Last Thursday, President Obama signed H.R. 2, the Medicare Access and CHIP Reauthorization Act, into law. Also known as the Sustainable Growth Rate (SGR) package or the “permanent doc fix,” the bill permanently repealed Medicare’s often-criticized physician payment system. The House and Senate each drew support from both sides of the aisle to pass the legislation, with the House voting for the bill 392-37 on March 26 and the Senate voting for the same language with a vote of 92-8 on April 14.
Optimism for continued bipartisan cooperation continues to linger in both chambers as lawmakers refocus on other health care issues. In the House, the Committee on Energy and Commerce is expected to release its latest draft of the 21st Century Cures Act by the end of the month. The language will stem from the 21st Century Cures Initiative, a bipartisan effort that, through hearings, roundtables, and white papers, explored topics including: innovating public health agencies, incorporating patient perspectives into the regulatory process, meeting unmet patient needs, improving medicine, and modernizing medical product regulation. A previous discussion draft was released in late January.
On Tuesday, the Senate Committee on Commerce, Science, and Transportation Subcommittee on Communications, Technology, Innovation, and the Internet will hold a hearing to explore telemedicine advancements. The hearing is to focus on the progress of public and private entities to expand telehealth services, especially in rural areas, and the connectivity challenges facing providers and patients. On Thursday, the Senate Committee on Finance Subcommittee on Health with again look at Affordable Care Act implementation, holding a hearing that will consider the medical device tax’s effect on patients, the health care sector, and the economy.
This Week’s Hearings:
- Tuesday, April 21: The Senate Committee on Commerce, Science, and Transportation Subcommittee on Communications, Technology, Innovation, and the Internet will hold a hearing titled “Advancing Telehealth Through Connectivity.”
- Tuesday, April 21: The Senate Committee on Veterans’ Affairs will hold a hearing titled “Fulfilling the Promise to Women Veterans.”
- Thursday, April 23: The House Committee on Veterans’ Affairs Subcommittee on Health will hold a hearing titled “Draft Legislation to Improve Reproductive Treatment Provided to Certain Disabled Veterans; Draft Legislation to Direct the Department of Veterans Affairs (VA) to Submit an Annual Report on the Veterans Health Administration; H.R. 271; H.R. 627; H.R. 1369; H.R. 1575; and H.R. 1789.”
- Thursday, April 23: The House Committee on Energy and Commerce will hold a hearing titled “Combatting the Opioid Abuse Epidemic: Professional and Academic Perspectives.”
- Thursday, April 23: The Senate Committee on Finance Subcommittee on Health will hold a hearing titled “A Fresh Look at the Impact of the Medical Device Tax on Jobs, Innovation, and Patients.”
EEOC Issues Proposed Rule on Wellness Programs
On Thursday, April 16, the Equal Employment Opportunity Commission (EEOC) released a proposed rule titled “Amendments to Regulations under the Americans with Disabilities Act,” which would clarify when employer wellness programs are in compliance with the Americans with Disabilities Act (ADA). Employers may offer employee health programs, such as exercise facilities and nutrition classes, with the aim of improving employees’ health and reducing health care costs. Wellness programs that are part of group health plans must additionally comply with the non-discrimination provisions of Health Insurance Portability and Accountability Act of 1996 (HIPAA), as amended by the Affordable Care Act (ACA).
Among other provisions, the proposed rule clarifies to be considered “voluntary” under the ADA, wellness programs that include disability-related inquiries or medical examinations may only offer incentives up to 30 percent of the total cost of employee-only coverage. The proposed rule drew limited support from Rep. John Kline (R-MN), who introduced H.R. 1189, Preserving Employee Wellness Programs Act, last month. The legislation would permit employee wellness programs to be tied to a financial incentive. Rep. Kline stated that while he was “encouraged” that the EEOC was taking action on this issue, he “reserve[s] the right to take legislative action if the agency continues to discourage innovative health plans that have helped control costs and improve lives of workers and their families.”
The proposed rule is scheduled for publication in the Federal Register on Monday, April 20. Comments are due 60 days thereafter.
CMS Proposes FY 2016 Hospital Payment Updates
On Friday, April 17, Centers for Medicare and Medicaid Services (CMS) issued a proposed rule titled “Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Policy Changes and Fiscal Year 2016 Rates; Revisions of Quality Reporting Requirements for Specific Providers, including Changes Related to the Electronic Health Record Incentive Program.”
The proposed rule includes updates to the FY 2016 payment policies and rates under the inpatient prospective payment system (IPPS) and the long-term care hospital (LTCH) prospective payment system (PPS). Notably, the proposed rule would establish two types of LTCH PPS payment rates, as mandated by the Pathways for SGR Reform Act of 2013. In addition to the standard LTCH PPS, a lower site-neutral LTCH PPS rate would be established for patients who meet certain clinical criteria. CMS projects that the lower site-neutral payment rate would reduce LTCH PPS payments by 4.6 percent, or approximately $250 million.
Comments on the proposed rule are due by June 16. CMS has stated that it expects to issue the final rule by August 1.
CMS Names New Medicaid Chief
On Friday, April 17, CMS Acting Administrator Andy Slavitt announced that Vikki Wachino has been named the top Medicaid official at the agency. Since December, Wachino has served as the Acting Director for the Center for Medicaid and CHIP Services (CMCS). Wachino has previously held roles at the Center for Budget and Policy Priorities, the White House Office of Management and Budget, and the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured.