House Passes Bill Redefining ACA’s Full-Time Work Week

On Thursday, January 8, the House passed legislation changing the Affordable Care Act’s (“ACA”) definition of a full-time work week from 30 to 40 hours.  The bill was sponsored by Rep. Todd Young (R-IN) and passed 252-172 with 12 Democrats supporting the measure.  The bill now moves to the Senate where Republicans will need to round up 60 votes to bring the bill to the floor for a vote. 

In a statement of administrative policy, the White House issued a veto threat saying the change “would significantly increase the deficit, reduce the number of Americans with employer-based health insurance coverage, and create incentives for employers to shift their employees to part-time work….”

The Congressional Budget Office (“CBO”) said the House bill would add $53.2 billion to the deficit between 2015 and 2025.  CBO also said that the legislation would reduce the number of employers having to pay penalties under the employer mandate and would increase spending on exchange subsidies.

Medical Device Tax Reintroduced

On Wednesday, January 7, Rep. Eric Paulsen (R-MN) and Rep. Ron Kind (D-WI) introduced a bill to repeal the medical device tax.  The device tax went into effect on January 1, 2013 and is a per-product tax on the sale of any taxable medical device by the manufacturer, producer or importer.

Medical device repeal legislation has been introduced in the last two Congresses.  It passed the house in 2012 and in 2013. It was reintroduced in 2014, gaining 275 cosponsors, but it never received a vote.  With Republicans now in control of the Senate, the odds increase that repeal legislation could reach the President’s desk.  However, since the device tax is a funding source for the ACA, it would most likely be subject to a Presidential veto, and it is doubtful that Republicans can muster the 67 votes needed to override a veto.

Final Rule on Charitable Hospitals Released

On Monday, December 29, the Internal Revenue Service and the Department of Treasury released the final regulations implementing the requirements for charitable hospitals imposed by the ACA.  The regulations cover, in part, how a charitable hospital must document and address community health and how it establishes a financial assistance policy and emergency care policy.

CMS Announces Changes to RAC Program

Last week, CMS announced a series of changes to the Recovery Audit Contractor (“RAC”) Program, including allowing RACs to review only six months of claims when determining whether patients were properly admitted.  CMS had proposed five changes to the program last February, when the agency began winding down the RACs in preparation for new contracts, then added the new changes last week.  The changes will take effect when the new contracts are awarded.

Bills Introduced This Week

Rep. Adrian Smith (R-NE) introduced legislation that would remove the 96-hour physician certification requirement as a condition of payment for inpatient critical access hospitals (“CAHs”).  The bill (H.R. 169) would not remove the requirement that CAHs maintain an average annual length of stay of 96 hours nor affect other certification requirements.

Rep. Shelia Jackson Lee (D-TX) introduced a bill (H.R. 42) that would require hospitals reimbursed under Medicare to establish and implement security procedures to reduce the likelihood of infant patient abduction and baby switching.

Sen. Amy Klobuchar (D-MN) introduced a bill (S. 31) that would amend Title XVIII of the Social Security Act to require the HHS Secretary to negotiate covered Part D drug prices on behalf of Medicare beneficiaries.

Sen. Marco Rubio (R-FL) introduced a bill (S. 123) to repeal section 1342 of the ACA’s risk corridor program that distributes money from exchange plans that earned profits to exchange plans that suffered losses. Companion legislation (H.R.) 221 was introduced in the House by Rep. Andy Harris (R-MD).

Next Week in Washington

Both the House and Senate will be back for their second week in session.  The House and Senate will continue attempts to repeal provisions of the ACA ahead of the President’s State of the Union address on January 20.