Ways and Means Committee Holds Hearing on MACRA Implementation

On May 11, the House Ways and Means Subcommittee on Health hosted CMS Acting Administrator Andy Slavitt to discuss the administration’s implementation plan for the Medicare Access & CHIP Reauthorization Act of 2015 (“MACRA”). At the hearing, Slavitt and members discussed the first MACRA-related proposed regulation, which was issued on April 27, and how the proposed rule can be improved before it is finalized later this year.

Slavitt highlighted the technical assistance that MACRA provides to small practices, rural practices and practices in medically underserved health professional shortage areas. This technical assistance could be provided by a host of national and regional entities to offer guidance and assistance to physicians and other clinicians. Slavitt also discussed how CMS would like to see the incorporation of unique device identifiers in electronic records and medical billing claims.

Senate Hotlines Mental Health Reform Bill

On May 10, Senate leadership asked Republicans whether they would support using a fast-track measure to approve the Mental Health Reform Act (S. 2680) on the Senate floor. Under the hotline process, a bill is brought to the Senate floor and passed without a formal vote. The mental health legislation was approved by the Senate HELP Committee in March and primarily addresses early intervention, mental health workforce shortage and opioid abuse.

A memo from the Senate Cloakroom asks Senators to either submit amendments to the bill or register an objection. The Senate Finance Committee may attach an amendment pertaining to the institutions for mental disease (“IMD”) exclusion, which prohibits Medicaid reimbursement for patients at hospitals with more than 16 psychiatric beds. However, the cost of fully repealing the IMD exclusion ($46 to $66 billion over 10 years) makes it unlikely the entire Senate would agree to the comprehensive IMD provision. Another controversial amendment may be offered by Sen. John Cornyn (R-TX), who has authored a mental health bill (S. 2002) that contains gun provisions backed by the NRA.

On the other side of Capitol Hill, Energy and Commerce Committee members remain at odds over provisions of the House mental health bill that deal with cost, HIPAA and assisted outpatient treatment programs. However, staff have told Hall Render the committee is prepared to take up and pass a less controversial mental health bill that comes over from the Senate, which might be the only chance for passing mental health reform this year.

House Preparing for Medicaid Reforms in 2017

In a statement this week, Rep. Brett Guthrie (R-KY) said the House Energy and Commerce Medicaid task force is in the process of formulating recommendations for Medicaid reform next year. Guthrie, who was appointed by Energy and Commerce Chairman Fred Upton (R-MI) to lead the task force, indicated the group has had several meetings on substantive Medicaid reform in 2017. While Guthrie hopes to produce a final product this fall that can be used for legislative action in 2017, Democrats have been critical of the task force, which is only composed of House Republicans.

Health-Related Bills Introduced This Week

Rep. Tom Price (R-GA) introduced a bill that seeks to prevent cuts to Medicare durable medical equipment (“DME”) reimbursement rates scheduled to take effect July 1, 2016. The bill (H.R. 5210) would extend the current reimbursement rates of DME in non-competitively bid areas in order to provide Congress with additional time to monitor its effects in rural areas. A companion bill (S. 2736) was introduced in the Senate by Sen. John Thune (R-SD).

Rep. Rosa DeLauro (D-CT) introduced a bill that would require health plans to provide coverage for a minimum hospital stay of 48 hours for mastectomies, lumpectomies and lymph node dissection for the treatment of breast cancer.

Next Week in Congress

Both the House and Senate return on Monday for a full work week. On May 17, the House Energy and Commerce Subcommittee on Health will hold a hearing on a legislative proposal (H.R. 5122) to prohibit CMS’s proposed Part B drug demonstration. The Senate is set to vote next week on several packages that would provide funding to address the outbreak of the Zika virus.