Ways and Means Advances Hall Render’s Stark Initiative
On September 13, the House Ways & Means Committee advanced three health care bills, including a revised version of the Stark Administrative Simplification Act of 2017 (H.R. 3726). The bipartisan bill, which passed unanimously, is the product of the coalition of hospitals and health systems created by Hall Render. The new measure was introduced by Reps. Kenny Marchant (R-TX) and Ron Kind (D-WI) and would allow hospitals to pay a fixed fee to CMS for technical violations of the Stark Law and create a new protocol for their resolution by CMS. The revised legislation will now be voted on by the full House and then proceed to the Senate where additional revisions are expected.
The committee also passed H.R. 3727, introduced by Rep. Diane Black (R-TN), to increase telehealth coverage. Currently, Medicare fee-for-service limits reimbursement to rural medical facilities, and the program only covers some types of remote monitoring. H.R. 3727 is intended to increase telehealth services through Medicare by removing some of the barriers to access. Earlier this year, the Senate Finance Committee passed similar legislation in the Medicare CHRONIC Care Act. Additionally, the committee advanced H.R. 3729, introduced by Reps. Devin Nunes (R-CA) and Terri Sewell (D-AL), to improve and extend add-on payments for Medicare’s ground ambulance transport program.
Senate Extends CHIP Funding
On September 13, leadership of the Senate Finance Committee agreed to a five-year funding extension for the Children’s Health Insurance Program (“CHIP”). Chairman Orrin Hatch (R-UT) and ranking member Ron Wyden (D-OR) announced that funding would be extended after many states repeatedly warned that they may have to freeze enrollment or send termination notices if funding was not renewed by September 30. The proposed legislation keeps the ACA’s 23 percent bump in funding but will start to phase it out in the next five years.
While the full legislative text to the CHIP bill has not been released by the committee, it appears the Senate legislation will remain relatively free of additional Medicare-related provisions.
Cassidy-Graham Bill Introduced as Last Effort to Repeal ACA
Sens. Lindsay Graham (R-SC) and Bill Cassidy (R-LA) introduced health reform legislation on September 13. Similar to the Senate’s failed Better Care Reconciliation Act, Cassidy-Graham would allow states to receive funding through block grants. The grants could be used for specific purposes like creating high-risk pools and helping individuals with out-of-pocket expenses or high premiums.
States receiving money could get a waiver from several key ACA marketplace reform provisions such as the medical loss ratio, community rating and essential health benefit packages. The bill repeals ACA provisions such as the medical device tax and the ban on using tax-free money for over-the-counter medication. It also revamps the Medicaid pay formula and sends a reduced amount back to the states in the form of block grants.
While the Cassidy-Graham bill has the support of rank and file Senate Republicans, it remains unclear if support exists from the moderate and conservative wings of the party. Republican leadership would have to move quickly to support this legislation because their ability to move the bill with a simple majority vote expires after September 30. Majority Leader Mitch McConnell (R-KY) asked the Congressional Budget Office (“CBO”) to provide an expedited ten-year cost estimate of the Cassidy-Graham legislation.
Energy and Commerce Advances Batch of Health Care Bills
On September 13, the House Energy and Commerce Committee advanced a series of bipartisan, Medicare-related bills. Many were similar to measures included in the Senate Finance Committee’s CHRONIC Care Act. The committee advanced H.R. 1148, the Furthering Access to Stroke Telemedicine Act introduced by Rep. Morgan Griffith (R-VA). This would expand access to Medicare-reimbursed neurological consultations via telemedicine for patients at hospitals or mobile stroke units.
The Committee also advanced the Medicare Civil and Criminal Penalties Act, authored by Reps. Gus Bilirakis (R-FL) and Kathy Castor (D-FL), to update penalties within the Medicare program. Neither penalty has been updated in 20 years. Additionally, the committee advanced legislation (H.R. 3120) introduced by Chairman Michael Burgess (R-TX). The legislation is intended to reduce the volume of future electronic health record-related significant hardship requests. It would amend the Health Information Technology for Economic and Clinical Health Act to remove the mandate that meaningful use standards become more stringent over time.
Health-Related Bills Introduced This Week
Rep. Richard Hudson (R-NC) introduced a bill (H.R. 3789) to amend Title XVIII of the Social Security Act to provide under the Medicare program for conditions of participation, reporting requirements and a quality program with respect to air ambulance services.
Sen. Orrin Hatch (R-UT) introduced a bill (S.1803) to improve medical research on marijuana. Sen. Hatch spoke on the Senate floor about the need to allow researchers to study the potential benefits of marijuana as a safe medical treatment for a wide range of diseases and disorders.
Rep. Elise Stefanik (R-NY) introduced the Community Health Investment, Modernization, and Excellence Act of 2017 (H.R. 3770). This bipartisan legislation would extend funds for community health centers.
Rep. Jackie Walorski (R-IN) introduced a bill (H.R. 3798) to amend the Internal Revenue Code of 1986 to repeal the 30-hour threshold for classification as a full-time employee and replace it with 40 hours for the employer mandate in the ACA.
Next Week in Washington
The House is out of session next week and returns the week of September 25. With Senate Republicans’ ability to use the budget reconciliation process expiring in 16 days, they will return Monday to make a final two-week push to repeal the ACA. The CBO will most likely release a cost estimate on the Cassidy-Graham ACA replacement bill, which is needed to advance overall consideration of the bill.
For more information, please contact:
- John F. Williams III at (202) 370-9585 or jwilliams@wp.hallrender.com;
- Andrew C. Coats at (202) 370-9587 or acoats@wp.hallrender.com; or
- Your regular Hall Render attorney.
