Legislative Update: September 24, 2019

Congressional Outlook

Last week, the U.S. House of Representatives passed the bipartisan “Continuing Appropriations Act, 2020, and Health Extenders Act of 2019 (H.R. 4378)”. 
This legislation would extend funding for all federal agencies until November 21st, 2019, including for programs of the U.S. Department of Health and Human Services.  

H.R. 4378 is expected to pass the Senate by the end of the week and be signed into law by the President, thereby averting a potential government shutdown as current federal funding expires on September 30th.

In addition to providing federal funding appropriations, H.R. 4378 also extended Medicare and Medicaid funding for a variety of health programs. These include funding for the Community Health Center program; funding for the Teaching Health Center graduate medical education program; resources for the National Health Services Corps; and funding extensions for a handful of other Medicare and Medicaid programs that would otherwise expire on September 30th.

A link to a summary of H.R. 4378 can be found here.

Work Continues on Efforts to Lower Prescription Drug Costs

While work on federal appropriations is underway, lawmakers continue to push forward on hot-button health care items. Last week, Leader Pelosi and Chairs of the House Ways&Means, Energy&Commerce and Education&Labor Committees unveiled a much-awaited proposal to reduce prescription drug pricing. This proposal, called the “Lower Drug Costs Now Act (H.R. 3)” would provide the Medicare program new authorities to negotiate drug pricing for the top 250 most costly prescription drugs. The legislation would also establish an international pricing index to bring drug costs in line with prices paid outside the United States and would limit price increases to certain inflationary levels. H.R. 3 would also establish new limits on Medicare beneficiary out-of-pocket costs, with a new $2,000 cap on beneficiary drug spending.

A summary of H.R. 3 can be found here.

The House Energy&Commerce Committee has announced a legislative hearing on H.R.3 for Wednesday, September 25th. More information on the hearing can be found here: E&C hearing on H.R.3. Other House Committees are expected to hold hearings on H.R. 3 in the coming weeks.  

There is Still an Opportunity to Improve Medicare Home Health “PDGM” 

Finally, the Congress is scheduled to be in recess starting at the end of this week, returning Monday, October 14th. When lawmakers return, they will continue conversations about funding the government beyond November 21st and what to do about health care programs that are also expiring on that date. 

During this timeframe, the home health industry and advocates will once again have the opportunity to make the case to Congress about the pressing need to enact the “Home Health Payment Innovation Act (H.R. 2573, S. 433)”. 

This legislation would protect access to home health care by ensuring any PDGM payment changes are made based only on actual experience and data. The legislation would specifically prohibit any payment reductions until 2025 and cap any payment reduction at no more than 2% per year.

In October, it will be important for ElevatingHOME and VNAA members to urge their Members of Congress to support the PDGM legislation (H.R. 2573/S.433). 

The more lawmakers that agree to cosponsor and support the PDGM legislation, the better chance the legislation will be taken up by key Committees in time to fix PDGM before the January implementation. 

We appreciate your work in contacting your local lawmaker on this critical issue.

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