Legislation to Delay Bundled Payments Program Introduced
On March 23, Rep. Tom Price, M.D., (R-GA) introduced a bill (H.R. 4848) that would delay the Comprehensive Care for Joint Replacement (“CJR”) program set to go into effect next week. The bundled payment program, which CMS finalized via administrative rule in November, requires hospitals in nearly 70 regions to accept bundled payments for hip and knee replacements. CMS projects that the CJR payment model will save $343 million in five years.
Rep. Price’s legislation, known as the Healthy Inpatient Procedures Act of 2016, would push implementation to January 2018 and is intended to give hospital systems and other providers additional time to coordinate the care and payments. However, the limited number of legislative days left this year, lack of initial support from other lawmakers and almost certain opposition from the Obama Administration means it is very unlikely the measure will be passed into law.
House Passes Merger and Acquisition Legislation
On March 24, the House voted 235-171 to pass legislation intended to harmonize disparities in the way merger and acquisition reviews happen between the Federal Trade Commission (“FTC”) and the Department of Justice (“DOJ”), which lawmakers hope will bring more predictability to the process. Under existing law, the FTC and DOJ can both review proposed mergers. However, the agencies face different standards in court and utilize different processes when reviewing these transactions.
The legislation passed by the House this week (H.R. 2745) would eliminate the FTC’s ability to challenge a transaction without going to court and require the agency to meet the same preliminary injunction standards as the Justice Department. Sen. Mike Lee (R-UT) has introduced a similar bill in the Senate (S. 2102), but that legislation is not expected to be voted on this year.
House Judiciary Committee Postpones Markup on Medical Malpractice Bill
On March 22, the House Judiciary Committee postponed the mark up of a bill (H.R. 4771) to overhaul how damages are awarded in medical malpractice lawsuits after conservative Republicans on the committee complained that the measure infringed upon states’ rights. The Help Efficient, Accessible, Low-Cost, Timely Healthcare Act of 2016 would limit awards by setting new conditions for lawsuits arising from medical liability claims. The measure includes a $250,000 cap on non-economic damages, limits the amount of contingency fees that attorneys can charge and allows courts to require periodic payments, rather than lump sum awards, for future damages to prevent bankruptcies. It also creates a “fair share” rule, which allocates damages in direct proportion to fault and establishes guidelines for awards of punitive damages. The committee has not set a date for another hearing on the legislation.
CDC Releases New ICD-10 Codes
On March 22, the Centers for Disease Control and Prevention released close to 1,900 new diagnosis codes that will be added to the ICD-10 coding system for health care claims in fiscal year 2017. The codes include entries for conditions related to diabetes, mental health disorders, eye diseases and lower joint issues. In addition to the new diagnosis codes, more than 3,600 inpatient procedure codes will be implemented on October 1, 2016. The updated codes mark the end of a partial freeze on updates to the diagnosis codes prior to the ICD-10 implementation on October 1, 2015.
Health-Related Bills Introduced This Week
Rep. John Duncan (R-TN) introduced the HEALTHIER Act (H.R. 4819) to assist charitable organizations providing free health care to those in need by providing a one-time grant of $1,000,000 to any state that allows licensed medical professionals to travel to other states to volunteer their services. Ten states currently have similar laws in place.
Rep. Erik Paulsen (R-MN) introduced a bill (H.R. 4878) that intends to create a voluntary chronic care delivery program that would be open to Medicare beneficiaries with two or more chronic illnesses. The program would reimburse health plans and providers based on health outcomes of those patients. The bill would also encourage the expansion of telemedicine and other health technologies to deliver better care to patients.
Next Week in Washington
Both the House and Senate are out next week for Easter recess. The Senate returns on April 4, and the House returns on April 11.