Archives: Legislative Developments

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House of Representatives Approves Bill to Delay LTCH 25% Rule Implementation, Make Other LTCH Reforms, and Tighten Medicare Enrollment Moratorium Authority

On September 21, 2016, the House Ways and Means Committee approved H.R. 5713, the “Sustaining Healthcare Integrity and Fair Treatment Act of 2016” or “SHIFT Act.”  The primary focus of the SHIFT Act is to provide an additional delay in full implementation of the “25 Percent Rule” for long-term acute care hospitals (LTCHs).  The legislation … Continue Reading

House Approves Medicare ESRD Coverage, Rural Hospital Supervision Bills

On September 21, 2016, the House of Representatives approved HR 5659, the Expanding Seniors Receiving Dialysis Choice Act of 2016, which would allow Medicare beneficiaries with end stage renal disease (ESRD) to enroll in Medicare Advantage plans beginning in 2020. The House also approved HR 5613, to prevent CMS from enforcing a Medicare requirement for … Continue Reading

Energy and Commerce Committee Clears Public Health Bills

On September 21, 2016, the House Energy and Commerce Committee unanimously approved the following public health bills: H.R. 4365, Protecting Patient Access to Emergency Medications Act – to amend the Controlled Substances Act (CSA) to enable paramedics and other emergency medical services (EMS) professionals to continue to administer controlled substances to patients under standing orders … Continue Reading

Congressional Hearings Focus on Health Policy Issues

A number of recent Congressional hearings have focused on health policy issues, including:  Senate Health, Education, Labor, and Pensions Committee hearings on laboratory testing in the era of precision medicine, and the safety of cosmetics. A House Judiciary Committee hearing on “Treating the Opioid Epidemic: The State of Competition in the Markets for Addiction Medicine.” … Continue Reading

Congressional Health Policy Hearings, Markups Resume After Summer Break

Congress has returned from recess, and health care policy continues to be on the agenda. The following health-related hearings and markups were held this week: The House Ways and Means Committee approved H.R. 5942, a bill to establish a demonstration program to provide integrated care for Medicare beneficiaries with end-stage renal disease, and H.R. 954, … Continue Reading

Obama Administration, Congress Take Steps to Fight Opioid Epidemic

HHS has announced a series of actions to address the nation’s opioid epidemic, as Congress has cleared the Comprehensive Addiction and Recovery Act for the President’s signature. As part of the HHS activities, the Substance Abuse and Mental Health Services Administration (SAMHSA) has published a final rule to expand from 100 to 275 the number … Continue Reading

House of Representatives Approves Mental Health System Reform Bill

The House of Representative has overwhelmingly approved a bipartisan bill (H.R. 2646, the Helping Families in Mental Health Crisis Act) to reform the nation’s mental health care system. Key provisions of the legislation would: provide grants to increase access to treatment for children with mental disorders and individuals with serious mental illness and fund various … Continue Reading

Committees Approve Rural Hospital Relief, ESRD Benefits, Medical Countermeasures Bills

On July 13, 2016, the Ways and Means Committee approved HR 5659, which would enable Medicare beneficiaries with end stage renal disease (ESRD) to enroll in Medicare Advantage plans. Earlier this month, the Committee approved HR 5613, to prevent CMS from enforcing a Medicare requirement for direct physician supervision of certain outpatient therapeutic services furnished … Continue Reading

Ways and Means Approves Bill to Delay LTCH 25% Rule Implementation, Make Other LTCH Reforms

On July 13, 2016, the House Ways and Means Committee approved an amended version of H.R. 5713, the “Sustaining Healthcare Integrity and Fair Treatment Act of 2016” or “SHIFT Act.” The primary focus of the SHIFT Act is to delay further the full implementation of the “25 Percent Rule” for long-term acute care hospitals (“LTCHs”). … Continue Reading

Senate Passes Legislation to Delay Pending Medicare DMEPOS Fee Schedule Cuts Based on Competitive Bidding Prices

As previously reported, the Affordable Care Act mandates that CMS use pricing information from the durable medical equipment (DME), prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program (CBP) to adjust Medicare fee schedule amounts for items furnished in areas where the CBP is not implemented.  CMS is phasing in these adjustments.  Specifically, effective January 1, … Continue Reading

Energy & Commerce Committee Approves Mental Health System Reform Bill

The House Energy & Commerce Committee has unanimously approved an amended version of H.R. 2646, the Helping Families in Mental Health Crisis Act, which is intended to reform the nation’s mental health care system. Among other things, the bill would: provide grants to increase access to treatment for children with mental disorders and individuals with … Continue Reading

Recent Congressional Health Policy Hearings and Markups

A number of Congressional committees have recently considered legislation and/or held hearings on various health policy proposals.  The Ways and Means Committee approved seven bills related to health care coverage and tax policy, including various bills to: expand access to health reimbursement arrangements and health savings accounts; ease employer insurance coverage mandates for students and … Continue Reading

House Approves “Helping Hospitals Improve Patient Care Act of 2016”

The House of Representatives has approved H.R. 5273, the “Helping Hospitals Improve Patient Care Act of 2016,” as amended by the Ways and Means Committee in May. As previously reported, while the bill focuses on Medicare payment policies pertaining to hospitals (including long term care hospitals and hospital outpatient departments), it also addresses Medicare Advantage … Continue Reading

Ways and Means Committee Approves Bill to Make Reforms to Medicare Hospital and Other Payment Policies

The House Ways and Means Committee has approved an amended version of H.R. 5273, the “Helping Hospitals Improve Patient Care Act of 2016.”  While most of the provisions address Medicare payment policies pertaining to hospitals (including long term care hospitals (LTCHs) and hospital outpatient departments), certain other reimbursement policies, including Medicare Advantage and physician payment … Continue Reading

Recent Congressional Health Policy Hearings

Recent Congressional hearings focusing on health policy topics include the following: House Energy and Commerce Committee hearings on HHS cybersecurity responsibilities, Medicare and Medicaid program integrity, the Administration’s proposed Medicare Part B drug payment model, and patient-focused health insurance reforms. House Ways and Means Committee hearings on implementation of the Medicare Access & CHIP Reauthorization … Continue Reading

House and Senate Pass Dueling Zika Funding Bills; House Bill Faces Veto Threat

On May 18, 2016, the House of Representatives approved H.R. 5243, the Zika Response Appropriations Act, by a vote of 241-184.  The bill would provide $622.1 million to the federal agencies to fight the Zika virus, offset by rescissions of existing funds (including unobligated resources left over from the 2014 Ebola outbreak).  According to the … Continue Reading

Update on Physician-Owned Distributor (POD) Developments

For some time, we have been reporting on issues involving federal government scrutiny of physician-owned distributors (“PODs”). From the Department of Health and Human Services Office of Inspector General’s (“OIG”) issuance of the March 2013 OIG Special Fraud Alert (“Special Fraud Alert”), to the Reliance Medical Systems challenge to the Fraud Alert, to the subsequent failure … Continue Reading

Recent Congressional Health Policy Hearings

A number of recent Congressional hearings have focused on health policy topics, including the following: A House Energy and Commerce Subcommittee on Health hearing on “Medicare Access and CHIP Reauthorization Act of 2015: Examining Physician Efforts to Prepare for Medicare Payment Reforms.” A House Judiciary Constitution and Civil Justice Subcommittee hearing on oversight of the False … Continue Reading

President Obama Signs Zika Priority Review, Controlled Substances Laws

President Obama has signed into law S. 2512, which adds  Zika virus to the Food and Drug Administration priority review voucher program to encourage the development of treatments for neglected tropical diseases. In addition, the President has signed S. 483, the “Ensuring Patient Access and Effective Drug Enforcement Act of 2016.  This law amends the Controlled Substances … Continue Reading

Energy & Commerce Committee Hearing to Focus on Physician Preparation for MACRA Reforms (April 19)

On April 19, 2016, the House Energy and Commerce Subcommittee on Health is holding a hearing entitled “Medicare Access and CHIP Reauthorization Act of 2015: Examining Physician Efforts to Prepare for Medicare Payment Reforms.”  The hearing will focus on major physician organizations’ investments in the development of alternative payment models, quality measures, and practice improvements.… Continue Reading
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