Ways and Means Releases Draft Hospital Legislation

On Wednesday, November 19, the House Ways and Means Subcommittee on Health released draft legislation intended to improve hospital issues in the Medicare system.  The legislation addresses Medicare’s controversial “two-midnight” rule, short inpatient stays, outpatient observation status, the RAC audit program and the appeals process.

While the legislative draft is subject to change following a public comment period, the measure, as released, represents a preview of the 2015 agenda for House Republicans with respect to Medicare policies for hospitals.  Much of the draft language could be included in the next Sustainable Growth Rate package, which is expected to be passed before the current “doc fix” expires on March 31, 2015.  While the draft bill has not yet been scored by the Congressional Budget Office, it is expected to have broad Republican and some Democrat support.

Title I of the legislation addresses nine specific issues, including: repeal of the two-midnights payment reduction; a new hospital prospective payment system; the development of a new per diem rate for short lengths of stay; and a continued moratorium of the auditing of hospital inpatient short stays through the end of FY 2015. It also establishes smaller RAC commission fees for voluntarily settled claims that were initially denied.

Title II of the draft legislation contains 19 prioritized legislative goals, including: repeal of the Affordable Care Act’s moratorium on physician-owned hospitals; expanding access to Medicare data; and relief to critical access hospitals (“CAHs”).

Public comments should be sent to:  HDDWAMR@mail.house.gov.

Senate Letter Opposes Rural Hospital Cuts

On Tuesday, November 18, 27 Senators from 19 states wrote to President Obama in support of CAHs.  The letter asks the President to exclude from his FY 2016 budget proposal cuts to Medicare reimbursements for CAHs and language making it more difficult for rural hospitals to receive the critical access designation.

In the Administration’s past three budget requests, it has proposed a payment reduction for CAHs and the removal of CAH special designation for facilities located within 10 miles of another hospital.  The letter argues the 10 miles designation is arbitrary and does not consider the implications for access to health care in the communities served by CAHs.

House Selects Health Committee Leaders for Next Congress

This week, the two committees with primary jurisdiction over issues involving Medicare and Medicaid selected their leaders for the 114th Congress, which starts in January.  At the House Committee on Ways and Means, Republicans selected Paul Ryan (R-WI) to replace Rep. Dave Camp (R-MI) as the next chairman. On the Democrat side, Sander Levin (D-MI) is expected to continue serving as his party’s highest ranking member on the committee.

At the House Energy and Commerce Committee, Fred Upton (R-MI) will remain chairman.  On the Democrat side, Rep. Frank Pallone (D-NJ) defeated Anna Eshoo (D-CA) in a hotly contested battle for the ranking member position on the committee.  Although Eshoo had the support of House Minority Leader Nancy Pelosi, Pallone’s seniority and support from the Congressional Black Caucus carried him to a 100-90 vote victory.  Pallone has served as the ranking member of the Energy and Commerce Health Subcommittee for many years, and his deep knowledge of issues is expected to be welcomed by the health care industry.

Republicans also selected the new members to serve on the committee, which include Reps. Susan Brooks and Larry Bucshon of Indiana, Rep. Chris Collins of New York, Rep. Kevin Cramer of North Dakota, Rep. Bill Flores of Texas, Rep. Rich Hudson of North Carolina and Rep. Markwayne Mullin of Oklahoma.

CMS Creates New Data Office

On Wednesday, November 19, CMS announced the creation of the Office of Enterprise Data and Analytics.  The office is intended to collect and analyze data from various CMS programs that can support the agency’s efforts to shift from basing medical payments on the volume of services provided to better health outcomes and more efficient spending. Niall Brennan will lead this new effort.

Bills Introduced This Week

Rep. David Jolly (R-FL) introduced a bill (H.R. 5725) to repeal the individual health insurance mandate that was created by the Affordable Care Act.  The repeal would apply retroactively to any month beginning after December 31, 2013.

Sen. Ed Markey (D-MA) introduced a bill (S. 2942) that seeks to establish a hospital fund for the treatment of individuals with Ebola or other specified infectious diseases.  The bill has been referred to the Senate Committee on Health, Education, Labor & Pensions.

Next Week in Congress

The House and Senate will be out next week for the Thanksgiving holiday.  Both chambers return on December 1 for the final two weeks of the 113th Congress.