Health Legislation Hits House Floor

House Majority Leader Kevin McCarthy (R-CA) has announced that the following health-related bills will be considered this week under suspension of the rules: H.R. 1624, the Protecting Affordable Coverage of Employees Act, as amended, which provides that employers with 51 to 100 employees are small employers for purposes of health insurance markets; S. 139, the Ensuring Access to Clinical Trials Act of 2015, which permanently allows an exclusion under the Supplemental Security Income Program and the Medicaid program for the compensation given to those who participate in clinical trials focused on rare diseases or conditions; H.R. 2061, the Equitable Access to Care and Health (EACH) Act, which expands the religious conscience exemption under the health care reform law; and H.R. 3593, To extend the authorization to carry out the replacement of the existing medical center of the Department of Veterans Affairs in Denver, Colorado, and for other purposes. On Tuesday, September 29, the House may also consider H.R. 3495, the Women’s Public Health and Safety Act, which provides states with increased flexibility in excluding Medicaid providers who are involved in abortions.

House Committees To Address Reconciliation

House Committee on Ways and Means Chairman Paul Ryan (R-WI) has announced that the committee will hold a markup on Tuesday, September 29, to consider a reconciliation bill. While the bill language and a schedule for floor consideration remain unannounced, there is some expectation that the legislation could address unpopular Affordable Care Act provisions, such as those on the Cadillac Tax, the Independent Payment Advisory Board (IPAB), and employer and individual mandates.

Similarly, House Committee on Energy and Commerce Chairman Fred Upton (R-MI) has announced that the committee will hold a markup the same day to consider reconciliation recommendations, which would defund the Prevention and Public Health Fund in the health care reform law and defund Planned Parenthood.

Senate HELP Committee To Mark Up Health Bills

On Wednesday, September 30, the Senate Committee on Health, Education, Labor, and Pensions (HELP) will meet in executive session to consider three bills: S. 799, the Protecting Our Infants Act of 2015, which focuses on reducing the rise of prenatal opioid abuse and neonatal abstinence syndrome; S. 1893, the Mental Health Awareness and Improvement Act of 2015, which reauthorizes and amends programs related to mental health and substance abuse disorders; and S. 481, the Improving Regulatory Transparency for New Medical Therapies Act, which amends the Controlled Substances Act and the Federal Food, Drug, and Cosmetic Act in regards to drug scheduling recommendations and registration of manufacturers and distributors seeking to conduct clinical testing. Any nominations cleared for action will also be placed on the agenda.

House and Senate Committees To Examine Medicare Program on October 1

On Thursday, committees in both chambers will bring the Medicare program under their scrutiny. The House Committee on Energy and Commerce will consider possible enhancements to the program in a hearing titled “Examining Potential Ways to Improve the Medicare Program.” The hearing will focus on three pieces of legislation: H.R. 1934, the Cancer Care Payment Reform Act of 2015, which amends the Social Security Act to direct the Secretary of the Department of Health and Human Services to establish an Oncology Medical Home Demonstration Project; H.R. 556, the Prevent Interruptions in Physical Therapy Act of 2015, which adds physical therapists to the list of providers able to utilize locum tenens arrangements under Medicare; and H.R. ___, To amend title XVIII of the Social Security Act to make changes to the Medicare home health face-to-face encounter requirements.

The Senate Committee on Finance will hold a hearing titled “Improper Payments in Federal Programs,” which will focus on Medicare, Medicaid, and the Earned Income Tax Credit. The Honorable Gene L. Dodaro, Comptroller General of the United States, United States Government Accountability Office, is slated to testify.

This Week’s Hearings:

• Monday, September 28: The House Committee on Rules will meet to discuss H.R. 3495, the Women’s Public Health and Safety Act.

• Tuesday, September 29: The House Committee on Oversight and Government Reform will hold a hearing titled “Planned Parenthood’s Taxpayer Funding.”

• Tuesday, September 29: The House Committee on Energy and Commerce Subcommittee on Oversight and Investigations will hold a hearing titled “An Overdue Checkup: Examining the ACA’s State Insurance Marketplaces.”

• Tuesday, September 29: The House Committee on the Judiciary Subcommittee on Regulatory Reform, Commercial, and Antitrust Law will hold a hearing titled “Healthy Competition? An Examination of the Proposed Health Insurance Mergers and the Consequent Impact on Competition.”

• Tuesday, September 29: The House Committee on Ways and Means will hold a markup of “Legislative proposals in response to the reconciliation directive included in section 2002 of S.Con.Res. 11.”

• Tuesday, September 29: The House Committee on Energy and Commerce will hold a markup of reconciliation recommendations; H.R. 3242, The Child Nicotine Poisoning Prevention Act, which requires liquid nicotine to be sold in child-resistant packaging; and H.R. 8, the North American Energy Security and Infrastructure Act.

• Tuesday, September 29: The Senate Committee on Veterans’ Affairs will hold a hearing titled “Examining the Impact of Exposure to Toxic Chemicals on Veterans and the VA’s Response.”

• Wednesday, September 30: The House Committee on Science, Space, and Technology will hold a hearing titled “Dyslexia and the Need to READ: H.R. 3033, the Research Excellence and Advancements for Dyslexia Act.”

• Wednesday, September 30: The Senate Committee on Health, Education, Labor, and Pensions (HELP) will hold a markup to consider S. 799, the Protecting Our Infants Act of 2015; S. 1893, the Mental Health Awareness and Improvement Act of 2015; S. 481, the Improving Regulatory Transparency for New Medical Therapies Act; and nominations.

• Thursday, October 1: The House Committee on Energy and Commerce Subcommittee on Health will hold a hearing titled “Examining Potential Ways to Improve the Medicare Program.”

• Thursday, October 1: The Senate Committee on Health, Education, Labor, and Pensions (HELP) will hold a hearing titled “Achieving the Promise of Health Information Technology.”

• Thursday, October 1: The Senate Committee on Finance will hold a hearing titled “Improper Payments in Federal Programs.”

Regulatory Activity

ONC Releases Federal Health IT Strategic Plan

On Monday, September 21, the Office of the National Coordinator for Health Information Technology (ONC) released the “Federal Health IT Strategic Plan” for the years 2015 to 2020. With the input of over 35 agencies and the public, this document sets forth how the federal government intends to use health information technology (IT) to achieve high quality care, lower costs, and a healthy and engaged population. The strategic plan lays out four overarching, interdependent goals: (1) to advance person-centered and self-managed health; (2) to transform health care delivery and community health; (3) to foster research, scientific knowledge, and innovation; and (4) to enhance the nation’s health IT infrastructure. To measure the strategic plan’s success, ONC plans to collect data and issue a report on an annual basis.

Transition to ICD-10 Approaches  

Despite multiple delays and fears of a looming government shutdown, this Thursday, October 1, the tenth edition of the International Classification of Diseases (ICD-10) is scheduled to become the coding system of the United States. During a press call last Thursday, September 24, Centers for Medicare and Medicaid Services (CMS) Deputy Administrator Patrick Conway clarified that CMS has contingency plans in the event that the transition to ICD-10 coincides with the potential disruption of a government shutdown.

Additionally, CMS has made moves to help give providers time to become accustomed to the more complex ICD-10 coding set. In July, the agency announced that it will offer providers flexibility during the first year that ICD-10 is in place. During this time, Medicare claims will not be denied solely based on the specificity of the diagnosis code as long as they are from the appropriate family of ICD-10 codes.

CMS Issues CDLT Proposed Rule

On Friday, September 25, CMS issued a proposed rule titled “Medicare Program; Medicare Clinical Diagnostic Laboratory Payment System.” This proposed rule continues implementation of the Protecting Access to Medicare Act of 2014, which includes a requirement that CMS base Medicare payment rates for clinical diagnostic laboratory tests on private payor rates starting in the 2017 calendar year. Under this proposed rule, by March 31, 2016, certain laboratories would be required to report private payor rate and volume data to CMS for the period of July 1, 2015 to December 31, 2015. Based on the data received, CMS would post new Medicare rates by November 1, 2016; these rates would be effective on January 1, 2017. CMS Deputy Administrator Patrick Conway spoke out in support of this proposed rule, stating that “[m]odernizing Medicare’s payment for clinical lab tests is another example of our commitment to spending health care dollars more wisely.”

This proposed rule is scheduled for publication in the Federal Register on October 1. The deadline for comments is November 24.