Sens. Rob Portman (R-OH) and Debbie Stabenow (D-MI) are spearheading a letter calling on the Centers for Medicare & Medicaid Services (CMS) not to expand site-neutral payment cuts to grandfathered hospital outpatient clinics, as the agency has proposed for the 2019 Medicare Outpatient Prospective Payment System (OPPS).
The senators urge CMS to respect congressional intent and maintain the current outpatient reimbursement for all current and future services provided at grandfathered facilities.
On Monday, America’s Essential Hospitals issued an Action Alert asking members to encourage their senators to sign the letter.
Senate Passes Opioid Legislation, Nears Vote on Spending Bill
The Senate Monday evening approved 99-1 its long-awaited bipartisan legislative package to combat the opioid crisis.
The Senate legislation lacks two provisions in the House-passed opioid bill, H.R. 6, important to essential hospitals: a partial repeal of the Medicaid Institutions for Mental Diseases (IMD) exclusion and language to align rules on confidentiality of substance use disorder treatment records (42 CFR Part 2) with HIPAA standards. The Senate and House now must reconcile the differences in their bills through conference committee negotiations.
The Senate this week also is slated to vote on a minibus spending bill that appropriates funding for the Defense, Labor, Health and Human Services, and Education departments for fiscal year 2019, which starts Oct. 1. Sen. Richard Shelby (R-AL), head of the Senate Committee on Appropriations, said lawmakers likely will pass the combined spending package by the end of the week.
House Committee Passes Medicaid Bills
The House Committee on Energy and Commerce has passed five Medicaid-related bills, including:
- H.R. 3891, which clarifies the authority of state Medicaid fraud and abuse control units to investigate and prosecute cases of Medicaid patient abuse and neglect in any setting;
- the ACE Kids Act, H.R. 3325, to give states the option of providing coordinated care for children with complex medical conditions through a health home;
- the Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources, and (EMPOWER) Care Act, H.R. 5306, which, by reauthorizing the Money Follows the Person Demonstration Program, would help states rebalance their Medicaid long-term care systems;
- a bill to prohibit group health plans, health insurance issuers, prescription drug plan sponsors, and Medicare Advantage organizations from limiting certain information on drug prices; and
- a bill directing the Department of Health and Human Services to establish a public-private partnership to identify health care waste, fraud, and abuse.
America’s Essential Hospitals sent the committee a letter of support for the ACE Kids Act. The Congressional Budget Office (CBO) now will score the bills before they are brought to the House floor for a vote.
Upcoming Senate HELP Hearings
The Senate Committee on Health, Education, Labor, and Pensions will hold a Sept. 18 hearing on reducing health care costs and using transparency to lower spending and empower patients. The committee will hold a second hearing Sept. 27 on reducing health care costs that will focus on improving affordability through innovation.
