Skip to Main Content
Don't have an account? Create Account
Don't have an account? Create Account

On the Hill: SGR, Budget, DSH, 340B, ACA

On Tuesday, the House released H.R. 2-The Medicare Access and CHIP Reauthorization Act of 2015. The bill would fully repeal the sustainable growth rate (SGR) formula, which is the basis for the Medicare Physician Payment System. Without repeal, the SGR would cut Medicare physician payments beginning April 1. The legislation mirrors bipartisan legislation from the 113th Congress to repeal the formula. A section-by-section analysis of the bill was also released, and members of America’s Essential Hospitals have access to a more detailed analysis of the bill on our website.

Of particular interest to essential hospitals, the bill includes a one-year delay of Medicaid disproportionate share hospital (DSH) payment cuts mandated by the Affordable Care Act (ACA). These cuts wouldn’t begin until fiscal year (FY ) 2018. There is also a two-year funding extension for the Children’s Health Insurance Program (CHIP) in the bill. America’s Essential Hospitals worked diligently with congressional leadership and key committee members to ensure the Medicaid DSH cut delay was included in the SGR package.

Congressional leaders hope to pass final SGR legislation before the end of the month, but it is unclear if the measure will easily pass through both the House and the Senate. There is opposition from Senate Democrats on several provisions, including funding CHIP for only two years, as opposed to four. Additionally, with budget considerations simultaneously ongoing, it will be a heavy lift for both the House and Senate to pass the measures before the impending recess.

This week, both the House and Senate will work to pass their respective FY 2016 budget resolutions before adjourning for a two-week recess on Friday. The deadline for a final budget compromise between chambers is April 15, although Congress has failed to meet the deadline in past years. Congressional budget proposals are not signed into law by the president, but rather serve as a spending framework for the FY.

The House Republican budget proposal would fully repeal the ACA and eliminate the Independent Payment Advisory Board (IPAB), which was created under the ACA to reduce Medicare spending. The House proposal would also transition Medicaid into a block grant program and combine CHIP and Medicaid into a single block grant. Similarly, the Senate Republican budget proposal  would fully repeal the ACA and Medicaid expansion. It would also model the Medicaid program after CHIP, which is a block grant program.

On Tuesday, the House Committee on Energy and Commerce, Subcommittee on Health held a rescheduled hearing to examine the 340B Drug Pricing Program. The hearing was originally scheduled for March 5, but was postponed due to inclement weather in Washington. Hearing witnesses included representatives from the Health Resources and Services Administration, the Office of the Inspector General, and the Government Accountability Office. America’s Essential Hospitals issued an Action Alert on March 3 urging member hospitals to weigh in with their congressional representatives to underscore the importance of the 340B program and the critical need to keep program savings with essential hospitals to help stretch scarce federal resources and better serve our communities. America’s Essential Hospitals also submitted an official statement for the record at the hearing.

The House Committee on Ways and Means, Subcommittee on Oversight held a hearing Tuesday on the use of data to prevent Medicare fraud. Also in the House, the Committee on Energy and Commerce, Subcommittee on Oversight and Investigations will hold a hearing Thursday on prescription drug and heroin abuse. The Senate Committee on Health Education Labor and Pensions (HELP) will hold a hearing Thursday, Continuing America’s Leadership: Advancing Research and Development for Patients.



About the Author

Jocelyn Wiles was a former manager of legislative affairs at America's Essential Hospitals.

Previous Next
Test Caption
Test Description goes like this