HHS Report Projects Impact of Uncompensated Care on Hospitals

On Wednesday, September 24, HHS released a report that projected hospitals will save $5.7 billion in 2014 in uncompensated care costs due to the Affordable Care Act.  The report calculates that in the 26 states that accepted federal money to extend Medicaid eligibility, hospitals are expected to save up to $4.2 billion on uncompensated care.  In states that did not expand Medicaid, savings will total $1.5 billion. 

Since the Supreme Court made Medicaid expansion optional for states in 2012, the administration and its allies have worked to highlight the risks of turning down expansion and the federal funds states are declining by not expanding.  The report comes as several states are considering ways to extend Medicaid coverage. It acknowledges that the findings are preliminary and based in part on evidence such as quarterly hospital earnings reports and surveys conducted by hospital associations.

House Bill Seeks ACO Payment Reform

Late last Friday, September 19, Representatives Diane Black (R-TN) and Peter Welch (D-VT) introduced the ACO Improvement Act (H.R. 5558), which is intended to improve upon the ACO model by providing additional incentives focused on rewarding health outcomes over volume.

The bill would create a pilot payment program that would disburse Medicare funds based on health outcomes rather than fee-for-service.  It would also give ACOs tools to keep patients in-network and enable qualifying ACOs to provide telehealth and remote patient monitoring services.

With limited time remaining in this Congress, it is unlikely the legislation will advance in the lame duck session following the November elections.  However, with the current Medicare physician payment formula expiring in March 2015, this measure could move early in the next Congress.

Senate Bill Would Require Hospitals Receiving Federal Funds to Provide Plan B

Also late last Friday, September 19, Senator Patty Murray (D-WA) introduced a bill that would require any hospital that receives Medicaid or Medicare federal funds to offer emergency contraception to survivors of sexual assault, regardless of their ability to pay for the drug.  Under the legislation, the HHS Secretary would have to develop and distribute information to the public regarding emergency contraception and where it is available.

House Bill Exempts Indirect CME Payments from Reporting

Representatives Michael Burgess (R-TX) and Allyson Schwartz (D-PA) have introduced a bill that would amend Title XI of the Social Security Act to exempt from sunshine reporting requirements the indirect payments that drug and device manufacturers offer to continuing medical education ("CME") providers. Lawmakers have recently expressed concern over CMS's plan to strike the CME exemption in the Physician Sunshine Law's Open Payments program.  If enacted, the bill (H.R. 5539) would reverse CMS's plan to do away with the exemption.

The Physician Sunshine Law requires drug, medical device and group purchasing organizations to report payments to physicians, which are then posted on the Open Payments website.

Health Care-Related Bills Introduced This Week

There were no health care-related bills introduced this week.

Next Week in Congress

Congress remains out of session ahead of the November midterm elections.