Committee Releases Discussion Draft of 21st Century Cures Legislation

On April 29, the House Energy and Commerce Committee released the 21st Century Cures draft bill to accelerate the development and marketing of drugs and medical devices. The draft bill comes after eight committee hearings on the 21st Century Cures initiative since it was launched in 2014. The Energy and Commerce Health Subcommittee reviewed the latest draft during a hearing on April 30.

The document offers proposals to establish a process to advance the use of biomarkers to reduce the cost and duration of clinical trials and to utilize an accelerated FDA approval pathway for medical devices, vaccines and antibiotics. It also includes a section on “Medicare site-of-service price transparency,” which calls for a public website outlining the anticipated costs to the federal government and individuals of Medicare services payable to hospital outpatient departments or ambulatory surgical centers.

The Senate Health Committee is also working on a parallel legislative effort. The committee held a hearing on April 28 and is hoping to introduce legislation later this year.  It is unclear how much of the House proposal would be included in a Senate bill.

House Passes Budget Deal

On April 30, the House passed a final budget deal by a vote of 226-197.  According to House and Senate Republicans, the deal would provide “a path through reconciliation to repeal” the Affordable Care Act (“ACA”).  The proposal’s reconciliation instructions target the key congressional committees that have jurisdiction over the ACA.

The budget agreement proposes the same amount of Medicare savings as provided in the FY 2016 budget proposal as a target to extend the life of the Hospital Insurance Trust Fund. House and Senate committees of jurisdiction are tasked with identifying the Medicare reforms needed to bring spending levels under the ACA in line with the budget.  The proposal would cut Medicare spending by $430 billion over the next 10 years and accounts for the full $120 billion cost of the Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2), which was signed into law on April 16 to repeal Medicare’s sustainable growth rate formula.

CMS Issues Proposed Hospice Payment Rule

On April 30, CMS issued a proposed rule that would update FY 2016 Medicare payment rates for the Medicare Hospice Benefit.  As proposed, hospices would see an estimated 1.3 percent ($200 million) increase in payments for FY 2016.  CMS also proposed a new two-tiered payment system for routine home care and an add-on payment for when a hospice patient is visited by a registered nurse or social worker in the last seven days of life.

Once finalized, the payments will take effect on October 1, 2015.

CMS Issues Proposed Inpatient Psychiatric Facilities Rule

On April 24, CMS released a proposed rule outlining changes in Medicare payment policies and rates for inpatient psychiatric facilities under the Inpatient Psychiatric Facility Prospective Payment System (“IPF PPS”).  The agency proposes an $80 million, or 1.6 percent, increase in Medicare pay for FY 2016.

CMS also proposes an update to the IPF PPS wage index with the newest Office of Management and Budget indications of rural and urban areas, which would cause some providers to lose their rural status and their payment bump.  According to CMS, 37 providers would experience a status change from rural to urban and gradually lose their 17 percent rural adjustment by 2018.

Bills Introduced This Week

Sen. Mark Kirk (R-IL) introduced a bill (S. 1168) that would amend Title XVIII of the Social Security Act and is intended to preserve access to rehabilitation centers under Medicare.

Rep. Gregg Harper (R-MS) introduced a bill (H.R. 2066) that would promote and expand the application of telehealth under Medicare and other federal programs.

Next Week in Congress

The House will be out of session next week and will return on May 12.  The Senate returns at 3 PM on Monday for its fourth consecutive week in session.