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On the Hill: Budget Deal, Leadership, Medicaid Supplemental Payments Hearing

This week, President Obama signed the two-year, $70 billion budget agreement passed by Congress last week that would avert a sharp rise in Medicare Part B premiums, among other changes.

As a partial offset for freezing Part B premiums, the 143-page agreement would reduce payments – in some cases, by as much as half – to any new hospital outpatient facility or physician practice acquired after enactment and located 250 yards or farther from a hospital’s main campus. Those new facilities and practices would be paid through either the Ambulatory Surgical Center Payment System or Medicare Physician Fee Schedule, as opposed to the Outpatient Prospective Payment System (OPPS).

The agreement includes a grandfather exemption for existing facilities and practices, which would continue to be paid under the OPPS.

Upon learning of this damaging provision, America’s Essential Hospitals fought hard to exempt essential hospitals, including working with members of the House Committee on Rules to introduce an amendment proposing the exemption. The amendment failed on a party-line vote, but several Republican members of the Rules Committee expressed interest in working to help ensure access to care for low-income beneficiaries. America’s Essential Hospitals will continue working with lawmakers to protect our member hospitals and patients by removing or modifying this provision.

Last week, Committee on Ways and Means Chair Paul Ryan (R-WI) was elected House speaker, replacing Rep. John Boehner (R-OH), who retired at the end of October. Reps. Kevin Brady (R-TX) and Pat Tiberi (R-OH) are vying to replace Ryan as Ways and Means chair. Rep. Sam Johnson (R-TX) will temporarily hold the position until the Republican Steering Committee chooses the new chair.

In committee business, the House Committee on Energy and Commerce held a hearing on examining legislation to improve Medicare and Medicaid that included two bills on Medicaid supplemental payments. The Improving Oversight and Accountability in Medicaid Non-DSH Supplemental Payments Act (H.R. 2151) would develop guidance on how states may calculate providers’ non-disproportionate share hospital (DSH) supplemental payments and require states to annually report on these payments. The Medicaid Requiring Expenditures for Public Objectives to be Reflective of Total Spending Act (H.R. 1362) would require states to annually submit a report on how the state sourced its non-federal share of Medicaid funds.

The hearing witnesses included Rep. Lynn Jenkins (R-KS); Katherine Iritani, health care director at the Government Accountability Office (GAO); and Anne Schwartz, executive director of the Medicaid and CHIP Payment and Access Commission ( MACPAC).


About the Author

Walsh is a former senior manager of legislative affairs for America's Essential Hospitals.

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