Health Bill Clears House Subcommittee

On May 14, the House Energy and Commerce Health subcommittee passed the 21st Century Cures legislation by a unanimous vote.  A day earlier, the full committee released an updated draft of the Cures legislation. The legislation now heads to the full committee level, where a markup is expected next week. Despite the progress, the issue of paying for the legislation has yet to be resolved and the Senate most likely won’t address the Cures legislation until the fall.

The Cures legislation included some Medicare provisions that were left out of the previous draft. One such provision addresses telemedicine and calls for CMS and the Medicare Payment Advisory Commission (“MedPAC”) to study how Medicare could expand telemedicine reimbursement and directs both CMS and MedPAC to submit a report to Congress within a year. The legislation also includes a “sense of Congress” that state medical boards should create standard provider licensing requirements for telemedicine services.

Congress has been looking at options to increase Medicare’s telemedicine coverage, which currently has a very low reimbursement rate. However, the Congressional Budget Office estimates show that expanded coverage of telemedicine would add significant costs to the Medicare program.

The updated draft also includes a framework for ensuring interoperability of qualified electronic health records and health information technology for the first time. The draft creates a charter organization to work with the health information technology standards and policy committees to give HHS recommendations around interoperability and allows providers to exchange patients’ medical records under HIPAA without their express consent.

Senate Launches Effort to Pass Medicare Chronic Care Legislation

On May 14, Senate Finance Committee leaders announced the committee will develop legislation to improve chronic care coordination in fee-for-service Medicare. According to Finance Committee Chairman Orrin Hatch (R-UT), the committee will aim to pass the legislation by the end of 2015.

The Finance Committee plans to issue an invitation requesting all interested public and private sector stakeholders submit their ideas on ways to improve outcomes for Medicare patients with chronic conditions.

Hatch also announced the formation of a chronic care working group chaired by Sens. Johnny Isakson (R-GA) and Mark Warner (D-VA). The group will analyze potential legislative solutions to move Medicare away from fragmented care.

Senate Republican Drafts Legislation to Replace ACA

Freshman Senator Bill Cassidy (R-LA) announced plans to introduce a bill called the Patient Freedom Act next Thursday, May 21. The roll-out of the legislation is meant to serve as part of the response to the looming King v. Burwell Supreme Court case.

Sen. Cassidy’s legislation would allow states to opt out of the Affordable Care Act’s (“ACA”) mandates and instead receive tax credits for health savings accounts. The legislation is intended to work in tandem with Republican legislation coming out of the House Ways and Means Committee that would offer temporary assistance to the approximately 7.5 million people who could lose health care subsidies.

Sen. Cassidy expects the legislation to take one year to eighteen months to be rolled out and would allow states to decide to eliminate all mandates for employers, individuals and insurers immediately.

Bills Introduced This Week

Rep. Diane Black (R-TN) introduced a bill (H.R. 2247) that would require the HHS Secretary to provide for transparent testing to access the transition under the Medicare fee-for-service claims processing system from the ICD-9 to the ICD-10 standard.

Rep. Susan Brooks (R-IN) introduced a bill (H.R. 2325) that would amend Title XVIII of the Social Security Act to provide for a pharmaceutical and technology ombudsman under the Medicare program.

Next Week in Washington

The House and Senate are both in session next week. On May 12, Ways and Means Health Subcommittee Chairman Kevin Brady (R-TX) announced the subcommittee will hold a hearing titled, “Improving Competition in Medicare: Removing Moratoria and Expanding Access.” As mentioned above, the House Energy and Commerce committee will hold a full committee markup of the 21st Century Cures legislation.