House Speaker John Boehner Announces Retirement from Congress

In a meeting with House Republicans early September 25, Speaker John Boehner (R-OH) announced that he will give up the speakership and resign his seat in Congress effective at the end of October.  The move comes in the midst of a contentious debate between Boehner and House conservatives over whether a legislative package to keep the government running beyond September 30 should include a provision to defund Planned Parenthood. House conservatives have threatened to remove Boehner as speaker if he tries to pass legislation that does not include the defunding provisions.  However, since Boehner no longer has to worry about maintaining his speakership, he is free to work with Democrats to avoid a government shutdown by passing a funding measure that does not include language regarding Planned Parenthood.  That measure, which would continue funding for all government agencies and programs at current levels, including the Medicare and Medicaid programs, is expected to last anywhere from a few months to the end of the year.

Lawmakers Lead Bipartisan Letter to CMS on the Hall Render-Led Stark Law Initiative

On September 21, Reps. Charles Boustany (R-LA) and Ron Kind (D-WI) wrote to CMS with comments on the physician self-referral updates contained in the CY 2016 Physician Fee Schedule Proposed Rule, which was published in the Federal Register on July 15, 2015.  CMS is expected to release the final rule around the beginning of November.

Reps. Boustany and Kind are members of the House Ways and Means Committee and the authors of the Stark Administrative Simplification Act (H.R. 776).  The bipartisan duo commended CMS for the agency’s efforts to address many of the concerns set forth in the bill, which was a product of a Hall Render-led coalition of hospitals and health systems.  However, they expressed concern that the proposed rule, if finalized, would not cure the disproportionate nature of the penalties health care providers now face for technical violations of the Stark Law.  The lawmakers also questioned whether the proposed rule would cure the lack of predictability and certainty that occurs when resolving a technical violation that is disclosed through CMS’s current disclosure process.

The members encouraged CMS to look to H.R. 776 as the best approach to ease some of the burden the Stark Law places on health care providers.  The legislation would allow a health care provider to pay a fixed penalty of $5,000 when disclosing a technical violation made within one year of noncompliance.  The fine would increase to $10,000 if the disclosure is made more than a year after the date of technical noncompliance.  The bill defines technical noncompliance as an unwritten, unsigned or lapsed agreement that is otherwise compliant.  CMS would then have 90 days to determine whether the disclosure qualifies for the fixed penalty using criteria set forth in H.R. 776.  If CMS fails to act within 90 days, the disclosure would be deemed accepted.

The Stark Administrative Simplification Act could be marked up by the House Ways and Means Committee this fall as either a stand-alone measure or part of a hospital reform package.

Senate Health Committee Announces Hearing to Move Mental Health Legislation

Earlier this week, the Senate Health, Education, Labor, and Pensions Committee announced that it will mark up Sen. Lamar Alexander’s (R-TN) mental health bill, S. 1893, on September 30.  The bill focuses on helping students recover from traumatic events and helping teachers and school administrators recognize signs of mental illness in students.  It also targets HHS grant programs related to awareness, prevention and early identification of mental health conditions.

With three comprehensive mental health bills being discussed in the House and Senate, some form of mental health legislation is expected to move this fall.  House Energy and Commerce Chairman Fred Upton (R-MI) has indicated that moving mental health legislation is one of his top priorities.

Lawmakers Say CMS Rule May Hurt Home Health Providers

On September 18, a broad coalition of 133 House members wrote to CMS, urging the agency to reconsider a proposed rule that would cut Medicare home health payment rates by 1.72 percent in 2016 and 2017.  The letter, which was led by Reps. Greg Walden (R-OR) and Tom Price (R-GA), notes that the proposed pay cuts for 2016 and 2017 would be in addition to the 14 percent rebasing cut imposed on the home health industry in 2014.

The members also voiced their concern over the proposed home health value-based purchasing program that “would impose an incentive/penalty range of as much as 5 to 8 percent over a 5-year period” for potential home health providers.  The proposed rule was released by CMS in July.  The agency is expected to release the final rule around the beginning of November.

Bills Introduced This Week

No health care-related bills were introduced this week.

Next Week in Congress

The House and Senate return for a full week after an abbreviated work week due to Pope Francis’s visit to Washington.  Congress will have until midnight on September 30 to pass a measure to keep the government open.  The Senate is expected to pass a bill that keeps the government open without defunding Planned Parenthood, which comes after a similar bill that defunded Planned Parenthood failed to pass this week.

Also next week, the House Energy and Commerce Oversight and Investigations subcommittee will hold a hearing on September 29 regarding ACA exchanges and how they spend federal grants to build enrollment technology.  The Senate Finance Committee will hold a hearing to discuss improper payments made in Medicare, Medicaid and the Earned Income Tax Credit.