Legislative Activity

House To Possibly Consider Amended Reconciliation Bill

Last week, the Senate passed an amended H.R. 3762, the Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015, on a vote of 52-47. House Majority Leader Kevin McCarthy (R-CA) has stated that the House of Representatives could possibly consider the Senate-passed bill on the House floor this week. President Barack Obama is expected to veto the bill.

The Senate-passed bill includes provisions that repeal major provisions of the Affordable Care Act (ACA), including insurance subsidies, Medicaid expansion, federal operation of insurance exchanges, and the Cadillac and medical device taxes. The bill also defunds Planned Parenthood for one year and repeals provisions such as Obamacare’s reinsurance language and various taxes, such as the tanning tax.

House Committee To Hear Testimony From Acting Administrator Slavitt

On Tuesday, December 8, the House Committee on Energy and Commerce Subcommittee on Oversight and Investigations will hold a hearing titled “An Overdue Checkup Part II: Examining the ACA’s State Insurance Marketplaces.” Andy Slavitt, Acting Administrator of the Centers for Medicare and Medicaid Services, is slated to testify. The hearing is expected to explore sustainability challenges that state insurance exchanges are facing, as well as how federal grant dollars were utilized.

This Week’s Hearings:

• Tuesday, December 8: The House Committee on Energy and Commerce Subcommittee on Oversight and Investigations will hold a hearing titled “An Overdue Checkup Part II: Examining the ACA’s State Insurance Marketplaces.”

• Tuesday, December 8: The House Committee on Veterans’ Affairs Subcommittee on Health will hold a hearing titled “Legislative Hearing on: H.R. 3262; H.R. 3484; H.R. 4129; H.R. 4056; a Draft Bill to Amend the Veterans’ Benefits Programs Improvement Act of 1991 to Authorize VA to Sell Pershing Hall; and, VA’s Legislative Proposal Regarding Fiscal Year 2016 Construction Projects.”

• Tuesday, December 8: The House Committee on Foreign Affairs Subcommittee on Africa, Global Health, Global Human Rights, and International Organizations will hold a hearing titled “Drug Resistant Tuberculosis: The Next Global Health Crisis?”

• Tuesday, December 8: The Senate Committee on Health, Education, Labor, and Pensions (HELP) will hold a hearing titled “Opioid Abuse in America: Facing the Epidemic and Examining Solutions.”

• Wednesday, December 9: The House Committee on Energy and Commerce Subcommittee on Health will hold a hearing titled “Examining Legislation to Improve Health Care and Treatment.” The hearing is expected to cover the following pieces of legislation:

  • H.R. 921, the Sports Medicine Licensure Clarity Act of 2015, which provides protections for sports medicine professionals who provide medical services in secondary states;

  • H.R. 1209, the Improving Access to Maternity Care Act, which provides for the designation of maternity care health professional shortage areas;

  • H.R. 2713, the Title VIII Nursing Workforce Reauthorization Act, which extends advanced education nursing grants to support clinical nurse specialist programs, among other provisions;

  • H.R. 3441, the Accurate Education for Prenatal Screenings Act, which establishes education programs for patients and health care providers regarding cell-free DNA prenatal screening, among other provisions;

  • H.R. 4152, the Cardiac Arrest Survival Act, which clarifies liability protections on the use of automated external defibrillators in an emergency; and

  • H.R. 4153, the Educating to Prevent Eating Disorders Act of 2015, which establishes a pilot program to test the impact of early intervention on the prevention, management, and course of eating disorders.

• Wednesday, December 9: The Senate Special Committee on Aging will hold a hearing titled “Sudden Price Spikes in Off-Patent Drugs: Perspectives from the Front Lines.”

• Wednesday, December 9: The Senate Committee on Veterans’ Affairs will hold a markup of S. 290, the Increasing the Department of Veterans Affairs Accountability to Veterans Act of 2015, and S. 425, the vehicle for omnibus.

Regulatory Activity

MACPAC Releases Medicaid And CHIP Data Book

On Tuesday, December 1, the Medicaid and Children’s Health Insurance Program (CHIP) Payment and Access Commission (MACPAC) released a report titled “MACStats: Medicaid and CHIP Data Book,” which provides the most current data available on Medicaid and CHIP. In addition to an overview and statistics on Medicaid and CHIP, the report addresses the following topics: trends in Medicaid; Medicaid and CHIP enrollment and spending; Medicaid and CHIP eligibility; and measures of beneficiary health, use of services, and access to care. Of note, total FY 2014 Medicaid spending was $498.3 billion, an approximate eight percent increase from the prior year. Conversely, total CHIP spending in FY 2014 was $13.0 billion, a one percent decrease from the prior year.

MACPAC will hold its next public meeting in Washington, DC on Thursday, December 10.

CMS Justifies Payment Cut Under The Two-Midnight Rule

On Tuesday, December 1, the Centers for Medicare and Medicaid Services (CMS) published in the Federal Register a notice titled “Medicare Program; Inpatient Prospective Payment Systems; 0.2 Percent Reduction.” In October 2013, CMS adopted the two-midnight rule, under which auditors are instructed that a hospital stay is generally appropriate for Medicare Part A payment if an inpatient stay crosses at least two midnights. Because CMS actuaries estimated that the two-midnight policy would increase expenditures due to an expected net increase in inpatient stays, CMS instituted a 0.2 percent payment reduction under the inpatient prospective payment system.

This notice responds to the U.S. District Court for the District of Columbia’s October ruling in Shands Jacksonville Medical Center v. Burwell. In this case, numerous hospitals and associations, including the American Hospital Association, challenged the 0.2 percent payment cut under the two-midnight rule. Judge Randolph Moss sided, in part, with the hospitals and ordered the Department of Health and Human Services to better justify the payment cut and to reopen the policy for comments. This notice discusses CMS’s basis for the 0.2 percent payment reduction and invites public comment on this issue.

Comments are due by February 2, 2016.