Hall Render Discusses Health Law Reform on Capitol Hill
As part of ongoing initiatives to persuade Congress to reform the Stark Law and remove fraud and abuse law barriers that hinder the expansion of telemedicine, Hall Render attorneys recently conducted another round of meetings with congressional staff on Capitol Hill, including House Energy and Commerce Health Subcommittee Staff Director Ryan Long and Senate Finance Committee Minority Health Policy Staffer Kristen Welsh. While it is widely accepted that Congress will not take up fraud and abuse law reform or telemedicine issues during the post-election lame duck session, Hall Render learned that an attempt to achieve some level of reform is expected to take place when Congress reconvenes next year.
Hall Render’s Stark Law initiative is aimed at reforming the excessive penalties hospitals face for such minor technical violations as a lapsed or unsigned contract that otherwise meets all elements of the law. Its Telemedicine Initiative is designed to achieve reform of the Medicare fraud and abuse laws that restrict the donation of health IT and related services, which has proved to be a barrier to the adoption of electronic health records. A report issued this week by the Bipartisan Policy Center calls on CMS and OIG to extend the 2006 rules creating Stark Law exceptions and Anti-Kickback Safe Harbors, a proposal that Hall Render has learned may also be addressed next year in the Senate.
MedPAC Proposes Reducing Medicare Hospital Outpatient Payments
On October 4, the Medicare Payment Advisory Commission (“MedPAC”) proposed expanding an earlier recommendation that would significantly reduce Medicare hospital outpatient payments. The proposal builds on MedPAC’s March 2012 report to Congress, which recommended payments for evaluation and management services paid to hospital outpatient departments be lowered so they are equal to payments for physician offices.
Yesterday’s meeting discussed expanding the proposal to equalize payments to more expensive procedures. According to MedPAC’s analysis, expanding the equalization effort could save Medicare as much as $900 million a year. Congress generally gives weighted consideration to MedPAC recommendations. Given the looming fiscal cliff, this MedPAC cost cutting proposal will likely be a viable option for Congress between now and January 2013.
Senate Group to Convene Meetings on Fiscal Cliff
Beginning next week, a bipartisan group of eight senators will convene a series of closed door meetings to develop a policy framework for avoiding the “fiscal cliff” facing Congress at the end of 2012. The group hopes to include tax increases and structural changes to entitlements within the framework. The framework is expected to be along the lines of the Simpson-Bowles Debt commission plan.
The Simpson-Bowles commission voted to approve the recommendations to Congress in November 2010, but the plan failed to attract enough votes on the House floor. The proposal contains two significant health elements: changes to Medicare and Medicaid and replacing the Medicare physician payment formula. The proposal also called for capping federal health care spending to GDP plus 1%.
The eight Senators planning to convene next week include: Richard Durbin (D-IL), Kent Conrad (D-ND), Tom Coburn (R-OK), Michael Crapo (R-ID), Saxby Cambliss (R-GA), Mike Johanns (R-NE), Michael Bennet (D-CO) and Mark Warner (D-VA). Given the uncertainty of the elections, it is unlikely the group will be able to develop a firm plan prior to the November 6 elections.
IRS Announces Hearing on Proposed Charitable Hospital Requirements
The Internal Revenue Service (“IRS”) has scheduled an October 29 hearing on the Department of Treasury’s June 26 proposed rule implementing certain requirements for tax-exempt hospitals under the Affordable Care Act (“ACA”). Section 501(r) of the ACA requires nonprofit hospitals to implement a financial assistance policy, limit the amounts charged to those eligible for financial assistance and enact other provisions in order to keep their tax exemptions. The October 29 hearing should focus on those provisions.
Congressman Introduces Legislation Addressing Looming Doctor Shortage
While members are out, the House and Senate are still holding pro forma sessions until after the November elections. Last week, Congressman Joe Crowley (D-NY) introduced a bill, H.R. 6562, that would expand the current cap on the number of Medicare-supported training slots for physicians.
The legislation would increase the number of Medicare-supported residency positions by 15,000 (3,000 slots per year, over five years). In 1997, federal law froze the number of Medicare-supported hospital residency positions based on the number of residents that each hospital trained in 1996. According to Crowley’s staff, the cap has not been lifted or adjusted since that time.
For more information, please contact John F. Williams, III at 317.977.1462 or jwilliams@wp.hallrender.com.
Please visit the Hall Render Blog at http://blogs.hallrender.com/ for more information on topics related to health care law.
