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On the Hill: NOTICE Act, ACA, Federal Spending

The House wrapped up legislative business last week to head into the August district work period. The Senate remains in session and is working to complete business this week to begin its district work period.

Last week, Congress cleared a hospital-related bill, the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act, and sent the bill to the president’s desk to be signed into law. The measure will require hospitals to notify patients receiving observation services for 24 hours or more that they are receiving care as an outpatient as opposed to an inpatient. The notification must be provided to patients in plain language within 36 hours to clearly outline that they are not being treated as inpatients, which means potential differences in out-of-pocket expenses.

Members of the House Ways and Means Committee introduced three pieces of legislation relating to Medicare hospital payments. Rep. Kenny Marchant’s (R-TX) bill, H.R. 3288, would cap future growth in empirically justified Medicare disproportionate share hospital (DSH) payments and direct new funding in Medicare DSH to hospitals in states that have not expanded their Medicaid Program under the Affordable Care Act (ACA).

Health Subcommittee Chair Kevin Brady (R-TX) introduced two pieces of legislation. The first, H.R. 3292, would convert Medicare indirect medical education payments from a per-discharge add-on payment to a lump-sum payment. The second, H.R. 3291, would create a classification system that serves as a guide to connecting the inpatient and outpatient coding and payment systems for hospitals. America’s Essential Hospitals is analyzing the impact of these bills on our members and will provide feedback to the sponsors.

Senate Majority Leader Mitch McConnell (R-KY) indicated that he expects to move legislation to repeal  the ACA this fall. Unlike previous repeal efforts, this effort would use the budget reconciliation process, which blocks a potential filibuster and allows for a 51-49 vote to repeal the legislation. If the bill is successfully passed by both chambers, President Obama has indicated he would veto it.

Also scheduled for the fall are spending bills to keep the federal government running into fiscal year 2016, which begins Oct. 1. While the appropriations process was moving smoothly until last month, some members of  Congress are threatening to vote against any legislation that funds Planned Parenthood. While the end of the fiscal year is nearly two months away, Congress will only be in session for the final three weeks of September, potentially threatening a full or partial government shutdown.

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About the Author

Jocelyn Wiles is the manager of legislative affairs at America's Essential Hospitals.