Legislative Update: June 18, 2019

Congress has two more weeks in session before they adjourn for the July 4th recess at the end of next week. 

During this work period, policymakers continue to focus attention on high-profile issues, including proposals to reduce prescription drug pricing and policies to end “surprise” medical billing. 

At the same time, key Committees continue to work behind-the-scenes to determine which Medicare and Medicaid policies to consider this year. On June 4th, the Energy&Commerce Committee held a hearing to consider Medicare and Medicaid “extender” policies in their jurisdiction. Extender policies are laws that are expiring at the end of the fiscal or calendar year and must be re-authorized to continue. 

NOW IS THE TIME FOR ACTION ON HOME HEALTH PDGM

As Committees work to develop Medicare extenders legislation, they will also determine whether to include other Medicare proposals – such as those related to Medicare home health and PDGM – in their legislative packages. 

Given this, it is imperative that we continue to urge our Senators and House Members to sign on to the “Home Health Payment Innovation Act (S. 433/H.R. 2573). This legislation will ensure the new Medicare PDGM system does not result in unfair payment reductions.  Please click here for a quick and easy way to reach out to Congress. We urge ALL MEMBERS to reach out to Congress on PDGM before the July 4th holiday.

MORE INFORMATION ON SURPRISE BILLING PROPOSALS

While work on Medicare policies is underway, key Committees continue to ramp-up efforts to end surprise medical billing. To-date, Committees have released differing versions of proposals to end surprise medical billing. Each of the proposals aim to limit surprise billing in emergency care situations or in situations where a patient receives unexpected, out-of-network care in the hospital setting. A key difference among the proposals is how hospitals and doctors will be paid in cases of surprise billing. Proposals range from requiring a set “benchmark” rate to allowing hospitals and insurers to seek arbitration to resolve payment disputes.

Last week, the House Energy&Commerce Committee held a hearing on their proposal to protect patients from surprise medical billing. Information about that hearing can be found here.  The Senate HELP Committee has also put forward a proposal related to surprise billing. A summary of the HELP Committee proposal to curb surprise medical billing can be found here. The Committee will hold a hearing on this proposal today, June 18th. 

It is unclear when Committees will vote on surprise billing proposals, but the issue is expected to remain front-and-center into the coming weeks.