The House is expected this week to vote on a government spending bill after President Trump announced his administration has reached an agreement with House Speaker Nancy Pelosi (D-CA) to lift caps on discretionary spending and increase the debt limit.
The agreement would stop a $125 billion budget cut and increase defense and nondefense discretionary spending while raising the debt limit for two years, until July 31, 2021. Media reports indicate an extension of the 2 percent reduction to Medicare provider reimbursements, also known as the Medicare sequester, would partly pay for the increased government spending.
Legislative details for the budget agreement have not yet been released.
House Panel Advances Health Care Bills
The House Committee on Energy and Commerce last week marked up more than two dozen bills, including health care proposals to shield consumers from surprise medical bills and extend funding for expiring health care programs, such as Medicaid disproportionate share hospital (DSH) funding.
Bipartisan committee members agreed to incorporate both the No Surprises Act and the Territories Health Care Improvement Act into the Reauthorizing and Extending America’s Community Health (REACH) Act (H.R. 2328). The REACH Act would continue funding for community health centers, the National Health Service Corps, and teaching health center graduate medical education, among other programs. In addition, the legislation would eliminate scheduled cuts to Medicaid DSH funding for fiscal years (FYs) 2020 and 2021 and reduce the cut in FY 2022 from $8 billion to $4 billion, avoiding a total of $16 billion in reductions.
Notably, the committee approved an amendment from Reps. Raul Ruiz (D-CA) and Larry Bucshon (R-IN) to establish an independent arbitration process for provider charges higher than $1,250 when a provider and health plan cannot agree on an appropriate payment amount. The underlying legislation establishes a benchmark payment to out-of-network providers that is equal to the median in-network rate for the service in a geographic area.
The committee also accepted three other amendments to address surprise billing practices, including measures to:
- allow adjustments to the benchmark median in-network payment rate based on type of facility (“higher acuity” settings of care and case mix);
- require an audit process for median contracted rates; and
- prevent a health provider from seeking reimbursement from an individual who received care within that facility more than a year after the date of service. Providers that violate this term would be subject to a civil monetary penalty
The surprise billing legislation now heads to the House committees on Education and Labor and Ways and Means for markup, which will likely take place after the August recess.
Health Bills Head to House Floor
Meanwhile, the full House this week will consider several bills advanced by the Energy and Commerce committee, including:
- the Emergency Medical Services for Children Program Reauthorization Act of 2019 (H.R. 776), which would reauthorize the Emergency Medical Services for Children Program through FY 2024;
- the Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act of 2019 (H.R. 1058), which would reauthorize funding for programs and research related to autism at the National Institutes of Health, the Centers for Disease Control and Prevention, and the Health Resources and Services Administration; and
- the Newborn Screening Saves Lives Reauthorization Act of 2019 (H.R. 2507), which would reauthorize screening programs for newborns for five years.
Senate Finance Committee to Markup Drug Pricing Legislation
On Thursday, the Senate Finance Committee will consider the Prescription Drug Pricing Reduction Act of 2019, authored by Committee Chair Chuck Grassley (R-IA) and Ranking Member Ron Wyden (D-OR).
The bipartisan legislation seeks to reduce prescription drug prices by requiring drug manufacturers pay a rebate to the Medicare program for price increases that are higher than inflation. The legislation also would change the Medicare prescription drug benefit to reduce out-of-pocket spending for Medicare beneficiaries, among other proposals.
The Congressional Budget Office estimates the legislation would save the federal government $100 billion over 10 years and lower premiums and out-of-pocket costs for Medicare beneficiaries by $32 billion over the same period.
House Passes Cadillac Tax Repeal
The House last week voted to repeal a 40 percent tax on high-value health coverage established by the Affordable Care Act.
The Middle-Class Health Benefits Tax Repeal Act (H.R. 748) would permanently repeal the tax on high-cost, employer-provided health plans scheduled to take effect in 2022. Congress has acted multiple times to delay this tax. The measure now heads to the Senate.