Congress Passes Post-Acute Care Bill

On September 18, the Senate passed, by unanimous consent, a bill that would require post-acute care providers to submit standardized data on its services. The bipartisan legislation (H.R. 4994), which was passed by the House a day earlier,  also requires HHS and the Medicare Payment Advisory Commission ("MedPAC") to provide Congress with new models for post-acute care payments, such as using bundled or site-neutral payments.

Currently, post-acute care facilities have different ways of determining patients' conditions so payments and outcomes can't be compared across settings. MedPAC, which is a non-partisan legislative branch agency tasked with advising Congress on Medicare issues, emphasized the need for a common, standardized assessment tool in a March 2014 report that reflected the views of over 70 stakeholders.

The bill's authors believe the standardized data would enable Congress to compare post-acute care across different settings and draft legislation to reform Medicare post-acute care payments. The bill was originally set for a House vote the final week of July but was pulled due a payment offset demand from the House Budget Committee.

House Introduces Meaningful Use Bill

On September 17, Rep. Renee Ellmers (R-NC) introduced a bill intended to provide hospitals more flexibility in meeting meaningful use requirements for electronic health records ("EHRs") in 2015. The legislation (H.R. 5481) would allow providers to show meaningful use of EHRs for 90 days, as opposed to a full year, in order to qualify for Medicare and Medicaid EHR incentive payments.

The 2015 reporting year is set to start on October 1 for hospitals. Many providers were looking for CMS to provide extra time in 2015 to update EHR systems, but CMS opted instead to require a full-year of reporting for hospitals. Given the short window left in the legislative session, this legislation is not expected to move this Congress.

MedPAC Considers Payment Change for Short Hospital Stays

In a meeting late September 12, MedPAC discussed how hospitals are paid for brief in-patient stays. In particular, the panel explored the issue of one-day stays and whether hospitals are admitting people who could have been treated at cheaper out-patient rates.

While the advisory panel reached no clear consensus on the issue, the commissioners began mulling policy responses that include changing payments for one-day stays and ways to help patients avoid unreimbursed admissions to skilled nursing facilities. MedPAC staffers noted that one-day stays are more common and profitable than longer stays because of the way the Medicare diagnosis related group system pays for inpatient care.

MedPAC will issue its annual report to Congress in March, 2015.

Bills Introduced This Week

Rep. John Sarbanes (D-MD) introduced a bill that would establish a demonstration program to facilitate physician reentry into clinical practice to provide primary health services. The bill (H.R. 5498) would establish a grant program for medical schools, hospitals and non-profit organizations to create or expand their physician reentry programs, which give physicians a streamlined process for credentialing and continuing medical education to return to medical practice after an absence.

Sen. Cory Booker (D-NJ) introduced a bill that would direct the HHS Secretary to develop guidelines on reducing health disparities. The legislation (S. 2841) would also provide for a study by the Institute of Medicine on health disparities.

Next Week in Congress

On September 19, the Senate passed a continuing resolution that averts a government shutdown by funding the federal government until December. The measure (H.J. Res 124), which now goes to the White House, was approved by the House a day earlier and included  language providing authorization for the military to train and equip Syrian rebels to fight ISIS. With the Government funded until December, the House and Senate may not return until after the November elections.