The House of Representatives has taken action on a number of bills to modify certain Affordable Care Act (ACA) provisions, revise Medicare Advantage policies, and make other health policy changes.
On June 23, 2015, the House voted to approve H.R. 1190, a bill to repeal the Independent Payment Advisory Board (IPAB), by a vote of 244 to 154. The IPAB was established by the ACA to submit Medicare spending plans to Congress if projected spending growth exceeds specified targets. Under the ACA, future IPAB’s proposals would go into effect automatically unless Congress enacts alternative legislation achieving required savings levels. IPAB members have not been appointed, and the spending trigger for IPAB recommendations has not yet been reached. The Administration has expressed its opposition to the bill, noting that while the IPAB “is not projected to be needed now or for a number of years given recent exceptionally slow growth in health care costs, it could serve a valuable role should rapid growth in health costs return.”
This action follows House approval last week of H.R. 160, a bill to repeal the ACA medical device tax, applicable to sales in calendar quarters beginning after the date of enactment. The Administration also opposes enactment of this legislation on grounds that it would increase the deficit. In other action, the House also approved the following health policy bills last week:
- H.R. 2570, “Strengthening Medicare Advantage through Innovation and Transparency for Seniors Act of 2015.” This bill, as amended, would: modify the treatment of patient encounters in ambulatory surgical centers in determining meaningful electronic health record (EHR) use; establish a demonstration program requiring the utilization of Value-Based Insurance Design under Medicare Advantage (MA) plans to demonstrate that reducing the copayments or coinsurance charged to Medicare beneficiaries for selected high-value prescription medications and clinical services can increase their utilization and ultimately improve clinical outcomes and lower health care expenditures; and set payment amounts for Part B drugs infused through durable medical equipment items using the average sales price plus 6 percent methodology (rather than 95 percent of the average wholesale price), effective January 1, 2017.
- H.R. 2507, “Increasing Regulatory Fairness Act of 2015”– to require the HHS Secretary to establish an annual rulemaking schedule with notice and comment period for updates to MA rates and certain other major MA policy changes.
- H.R. 2505, “Medicare Advantage Coverage Transparency Act of 2015” — to require CMS to report certain MA enrollment data to Congress.
- H.R. 2582, the “Securing Seniors’ Health Care Act of 2015” — to delay the Secretary’s authority to terminate Medicare Advantage contracts for plans failing to achieve minimum quality ratings, to make improvements to the Medicare Adjustment risk adjustment system, and for other purposes.