House Ways and Means Committee Advances Medicare Program Integrity Bill

On Thursday, February 26, the House Ways and Means Committee approved four bills, including a broad Medicare anti-fraud bill and a measure that would require hospitals to notify patients when they are considered to be under observation status.  The anti-fraud bill (H.R. 1021) was introduced earlier in the week and incorporates a number of Medicare reforms that include:  establishing a Medicare Administrative Contractor (“MAC”) outreach and education program; extending MAC contracts to 10 years; and allowing nurse practitioners and physician assistants to document face-to-face encounters for Medicare-covered durable medical equipment prescriptions.

The committee also approved a measure regarding observation status for hospital patients.  Under legislation introduced by Rep. Todd Young (R-IN), hospitals would be required to tell patients if they were being classified as an outpatient under observation status rather than admitted on inpatient status.  Under the bill, any such notification would have to explain to the patient why the hospital classified them as an outpatient under observation status and explain cost sharing requirements associated with the classification.

Medicaid Physician Self-Referral Bill Introduced

On Wednesday, February 25, Rep. Jim McDermott (D-WA), the ranking member of the House Ways and Means Subcommittee on Health, introduced a bill (H.R. 1083) that seeks to clarify that Stark Law claims apply to Medicaid services in the same way it applies to Medicare health services.  The legislation also seeks to establish a Medicaid Self-Referral Disclosure Protocol (“SRDP”) consistent with the requirements of the current Medicare SRDP created in the Affordable Care Act.  Similar legislation was introduced last May by Rep. McDermott but failed to move in the House.

CMS Delays EHR Meaningful Use Deadline

On Wednesday, February 25, CMS announced it will delay the deadline for attesting to the Electronic Health Record (“EHR”) meaningful use program from February 28 to March 20 at 11:59 PM ET.  CMS is also extending the Physician Quality Reporting System deadline for those participating in the meaningful use program to March 20 at 8 PM ET.  In an email to stakeholders, CMS says the Medicare meaningful use extension does not affect deadlines for the Medicaid EHR program.

CMS Announces It Is Prepared for ICD-10 Implementation

On Wednesday, February 25, CMS announced its first end-to-end tests of ICD-10 detected few problems with the new billing code system and that CMS systems are ready for ICD-10 implementation. The announcement comes as House Republicans have urged the Obama Administration to further put off ICD-10 implementation or set up a transition period.  The tests were the first of three testing weeks before ICD-10 implementation on October 1, 2015.

Bills Introduced This Week

Sen. John Thune (R-SD) introduced a bill (S. 584) that would enable Medicare beneficiaries to receive Medicare benefit notices electronically and seeks to improve the way CMS contracts with Medicare Audit Contractors.  The House version of the Thune bill was included in the Medicare anti-fraud bill discussed above.

Sen. Ben Cardin (D-MD) introduced a bill (S. 539) to amend Title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps.  The bill seeks to fully repeal the limits currently placed on outpatient physical therapy, occupational therapy and speech pathology services to Medicare beneficiaries.

Rep. Kathy Castor (D-FL) introduced a bill (H.R. 1117) that would amend the Public Health Service Act to authorize grants for graduate medical education partnerships in states with a low ratio of medical residents relative to the general population.

Next Week in Washington 

While the House and Senate are scheduled to be in session next week, both could remain in session over the weekend to debate funding for the Department of Homeland Security.  On Wednesday, March 4, the Supreme Court will hear arguments on the King v. Burwell case, which could end Affordable Care Act subsidies in the 34 states that use federally run exchanges.