Senate Votes Down ACA Repeal Attempt
In the early morning of July 28, the Senate voted down (49-51) a last ditch effort by Senate Republican leadership to repeal the ACA. Republican leadership and the White House were hoping to pass a “skinny” ACA repeal bill that would have eliminated the individual mandate and blocked the employer mandate for eight years. Sens. Susan Collins (R-ME), Lisa Murkowski (R-AK) and John McCain (R-AZ) voted against the bill. Sen. McCain was unhappy that the bill wasn’t vetted through the normal legislative process known as “regular order” where legislation receives a committee hearing and is subject to amendment.
The bill would have also increased the limit on health savings accounts contributions, extended the moratorium on the medical device tax, made changes to the 1332 waiver program and added $422 million for community health centers. The Congressional Budget Office estimated that the bill would save $178 billion over the next decade. However, it was unclear if the House and Senate would have reconciled the differences in conference to vote out a single bill.
With the defeat, Senate Majority Leader McConnell (R-KY) indicated he would be open to working with Democrats on reforms beyond just stabilizing the ACA marketplace. Some Senate Republicans have indicated they would be willing to work with Democrats on a short-term stabilization patch. The White House and HHS will also need to determine how long they will continue funding cost-sharing subsidies, the ACA enrollment outreach and enforcement of the individual and employer mandate. The next payment from HHS to insurers is in three weeks.
Committee Seeks Provider Feedback on Legislative and Regulatory Relief
On July 24, the House Ways and Means Committee announced an initiative to seek legislative and regulatory changes to Medicare providers. The initiative is known as the Provider Statutory & Regulatory Relief Initiative and has three stages. The first requests feedback from stakeholders. The Committee will then host roundtables, and the final stage will be congressional action on the recommendations. Providers can submit feedback to the committee by August 25, 2017.
CMS Releases 2018 Home Health Payment Rule
On July 25, CMS released the calendar year (“CY”) 2018 proposed payment rule for home health agencies. The rule would reduce Medicare payments to the agencies by 0.4 percent next year, saving the federal government an estimated $80 million. The proposed rule would be effective for home health episodes of care ending on or after January 1, 2018. CMS is also proposing a series of changes to the payment methodology beginning in CY 2019, which could result in a pay cut of up to 4.3 percent.
FDA Announced Pre-Certification Pilot Program
On July 27, the FDA announced its launch of a pre-certification pilot program that will allow proven technology and software companies to submit less pre-market information before marketing a new product. The program is part of the FDA’s Digital Health Innovation Action Plan. The plan details how the FDA’s device center will implement digital health-related 21st Century Cures provisions and issue draft and final guidance to help encourage digital health innovation.
Health-Related Bills Introduced This Week
Rep. Cathy McMorris Rodgers (R-WA) introduced a bill (H.R. 3394) that would reauthorize for three years, 340H of the Public Health Service Act to encourage the expansion, maintenance and establishment of approved graduate medical residency programs at qualified teaching health centers.
Rep. Bill Johnson (R-OH) introduced the Evidence-Based Telehealth Expansion Act of 2017. The bill (H.R. 3482) would allow the HHS Secretary to review existing services in the Medicare program to determine which are appropriate for telehealth and waive existing restrictions on those services.
Rep. Jeff Denham (R-CA) introduced the Teaching Health Center Graduate Medical Education Program. The bill (H.R. 3451) funds 240 new resident spots and would establish a minimum of 10 new residency centers. It also directs the HHS Secretary to prioritize centers located in counties with higher than 35 percent of the population enrolled in Medicaid.
Rep. Jackie Walorski (R-IN) introduced a bill (H.R. 3378) to amend Title XVIII of the Social Security Act to require reporting of certain data by providers and suppliers of air ambulance services for purposes of reforming reimbursements for such services under Medicare.
Rep. Gregg Harper (R-MS) introduced a bill (H.R. 3360) to promote and expand the application of telehealth under Medicare and other federal health care programs.
Next Week in Washington
The Senate is scheduled to return at 4:00 PM on July 31. However, with the defeat of ACA repeal, it is unclear if the Senate remains in session for the first two weeks of August or will adjourn until September. The House is scheduled to begin their August district work period and will not return until September 5. If the Senate does not return next week, This Week in Washington will not be published and will resume when Congress returns after Labor Day.
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