Comprehensive Post-Acute Care Reform Bill Introduced
On June 26, leaders of the Senate Finance and House Ways and Means committees introduced comprehensive post-acute care legislation. A summary of the legislation can be found here. According to a joint committee release, the legislation (H.R. 4994, S. 2553) would require data standardization to allow Medicare to compare quality across different post-acute care settings and improve hospital and post-acute care discharge planning. This information would then be used to reform post-acute care payments through the use of neutral or bundled payments or some other reform.
New Rule for ACOs at OMB
Also on June 26, the White House's Office of Management and Budget received CMS's proposed rule for the second round of the Accountable Care Organization ("ACO") program. The proposed rule would make changes to the Medicare Shared Savings Program ahead of the second round of contracts. The changes would apply to existing ACOs and approved ACO applicants participating in the program beginning January 1, 2016. New applications are due July 31 for a January 1, 2015 start date.
House and Senate Begin VA Negotiations
On June 24, lawmakers comprising a 28-member bicameral panel met for the first time to reconcile the differences between the House- and Senate-passed versions of the Veterans Administration ("VA") Hospital bills. Both bills would enable veterans living 40 miles from the nearest VA facility or facing long waits to opt for coverage at non-VA hospitals. However, the most contentious issue will be how to cover the cost of those veterans opting for non-VA health care. The Congressional Budget Office estimated that health care provisions in the Senate-passed bill would cost $35 billion and could cause veterans to seek additional care costing as much as $50 billion annually. The House's health care language was projected to cost $44 billion annually.
Congress Grills Officials Over Medicare Program Integrity Issues
On June 25, House Energy and Commerce members held a hearing to discuss ongoing Medicare fraud issues, including post-payment contractor reviews. Committee members voiced frustrations over Recovery Audit Contractors and the impact that extended length of post-payment reviews are having on their constituent providers. Government witnesses included officials from CMS, HHS Office of Inspector General and the Government Accountability Office. The witnesses detailed the Department's anti-fraud efforts and asked Congress for full funding of their 2015 budget request to increase Medicare oversight.
Bills Introduced This Week
Rep. Ami Bera (D-CA) introduced a bill (H.R. 4951) that would provide incentives to physicians to practice in rural and medically underserved communities, in order to shorten wait times at VA hospitals. The bill would also increase the number of J-1 visas allowed per state for doctors to practice at VA hospitals.
Sen. Tom Harkin (D-IA) introduced a bill (S. 2515) that would require states that have found an individual to be eligible for nursing home care to also be eligible for care in home- and community-based service settings.
Next Week in Congress
The House and Senate will be out next week for a week-long Fourth of July recess. When Congress returns on July 7, they will continue work on the fiscal 2015 appropriations bills.
Next week also marks the deadline for public comments to the first batch of Medicare provider payment updates for fiscal year 2015 payments. Comments are due next week on the main hospital inpatient schedule as well as hospital psychiatric and rehabilitation services. Also, proposed rules covering hospital outpatient payment updates are normally published in July.