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On the Hill: 300 House Lawmakers Urge DSH Cut Delay

A letter bearing the signatures of 300 House lawmakers and sent to House leaders this week makes a strong bipartisan call for a two-year delay of Medicaid disproportionate share hospital (DSH) cuts.

Reps. Eliot Engel (D-NY) and Pete Olson (R-TX) organized the letter-signing campaign, which America’s Essential Hospitals actively supported by rallying its members to urge their House representatives to sign the letter.

Unless Congress acts, a $4 billion cut to Medicaid DSH funding will take effect Oct. 1, 2019, the start of fiscal year 2020, and an $8 billion cut will occur in FY 2021. “Our nation’s hospitals cannot sustain losses of this magnitude. Institutions will be forced to shutter, leaving our constituents and communities without a vital safeguard,” lawmakers said in the letter, which seeks to delay both years’ cuts.

America’s Essential Hospitals issued a statement praising the results of the letter-signing campaign. “We applaud the letter’s organizers…and all their House colleagues for recognizing the severe threat posed by DSH payment cuts and standing up for patients, communities, and hospitals,” the association said.

Also this week, the Partnership for Medicaid, a nonpartisan, nationwide coalition that includes America’s Essential Hospitals, sent a letter to House and Senate leadership urging a delay of the impending Medicaid DSH cuts. More than a dozen organizations in the coalition signed the letter, including the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the Association for Community Affiliated Plans, the Catholic Health Association of the United States, the Children’s Hospital Association, the Jewish Federations of North America, the National Association of Community Health Centers, the National Association of Counties, the National Association of Pediatric Nurse Practitioners, the National Council for Behavioral Health, the National Hispanic Medical Association, and the National Rural Health Association.

House Vote on Drug Pricing, ACA Package

This week, the House will vote on a legislative package that combines several bipartisan drug pricing bills with measures aimed at protecting parts of the Affordable Care Act (ACA).

The package includes a series of bills (H.R. 938, H.R. 965, H.R. 1499) that seek to expedite the availability of generic prescription drugs. Other bills in the package (H.R. 987, H.R. 1010, H.R. 1385, H.R. 1386) aim to secure funding to bolster portions of the ACA, such as establishing state-based insurance marketplaces and ACA outreach and enrollment efforts. The legislation also would curb the administration’s action to expand the availability of short-term insurance plans.

Surprise Billing Principles

In remarks at the White House last week, President Trump announced his administration’s policy principles to address balance billing, or surprise billing, practices. He urged Congress to act by passing bipartisan legislation.

The president articulated general principles intended to protect patients from being billed for a remaining balance after receiving emergency care in out-of-network facilities or by out-of-network clinicians. For example, the principles would limit providers to sending a single “bundled” bill for services during an episode of care and require that patients seeking elective services receive advance notification when a clinician is out of their insurance network.

Sens. Bill Cassidy (R-LA) and Maggie Hassan (D-NH) both joined the president during the White House event. The pair are working toward introducing legislation this month to address surprise medical bills.

Legislation to Block Site-Neutral Cut

Reps. Derek Kilmer (D-WA) and Elise Stefanik (R-NY) introduced the Protecting Local Access to Care for Everyone (PLACE) Act (H.R. 2552) to block the Centers for Medicare & Medicaid Services’ (CMS’) expansion of the site-neutral payment cuts to clinic visits at grandfathered hospital outpatient facilities.

The expanded site-neutral cut took effect on Jan. 1 of this year and is expected to reduce hospital outpatient payments by $380 million in 2019.

Upcoming House Hearings

The House Committee on Ways and Means this week will hold hearings on the economic and health consequences of climate change and overcoming racial disparities and social determinants in the maternal mortality crisis.

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About the Author

Erin Delaney is the legislative affairs associate at America's Essential Hospitals.

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