Legislative Update: April 23, 2019

Congress is out of session this week. When lawmakers return on Monday, April 29, it is expected that prescription drug costs and legislation to shore up the health insurance marketplace will be a continued focus, particularly in the Democratic-led House of Representatives.

Specifically, it is possible that drug pricing and health insurance legislation that recently passed the House Energy & Commerce and Ways & Means Committees will be brought to the full House floor for a vote in May. More information about these bills can be found here: prescription drug legislation, health insurance legislation, and additional prescription drug bills.

In addition, Representative Sewell (D-7th-AL) is expected to introduce legislation in May related to the Medicare home health Patient Driven Groupings Model (PDGM). This legislation will be the House version of the “Home Health Payment Innovation Act (S. 433)” that was introduced in the Senate in February. 

This legislation would ensure the new Medicare home health PDGM system does not inappropriately reduce payments for home health services starting in fiscal year 2020. The proposal would also waive homebound rules for certain Medicare beneficiaries enrolled in Medicare Advantage or Medicare Shared Savings Programs.

ElevatingHOME will continue to provide updates on the PDGM legislation. In addition, once the PDGM proposal is introduced in the House, we encourage ElevatingHOME members to reach out to their local Member of Congress to express support for the legislation. We will provide contact and related information for your local Representative to assist in this outreach.

Finally, on Friday, April 19, the Centers for Medicare and Medicaid Services (CMS) released the FY2020 Medicare Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements proposed rule. The proposed rule would provide a 2.7% payment update in 2020. The legislation also solicits comments on how the hospice benefit interacts with various payment models, such as accountable care organizations (ACOs). 

Public comments on the hospice proposed rule must be submitted by June 18, 2019.

Upcoming Events

  • Monday & Wednesdays at 3:30 p.m. ET
  • Free for members, click here for registration details
  • Sept. 15-17 | Virtual
  • Nov. 10-12, 17-19 | Virtual