Medicare Payment and Reimbursement

Aug. 13-17: Senate to Vote on HHS Funding

August 10, 2018 8:57 am

The bill under consideration includes no new funding for the Affordable Care Act (ACA), but it does address some ACA policies.

 

Aug. 10—The U.S. Department of Health and Human Services (HHS) would receive a small increase and funding for several hospital priorities under a FY19 funding bill that the Senate is expected to vote on next week.

The FY2019 Labor, Health and Human Services, and Education (Labor-HHS) Appropriations Act, which was approved in June on a bipartisan 30-1 vote by the Senate Appropriations Committee, would increase HHS discretionary funding by $2.3 billion, or 2.45 percent, to $90.1 billion.

Hospital Priorities

Among funding in the bill for hospital priorities is $318.8 million for rural health care, or $28 million more than in FYsmall18. Those funds include $25.5 million, $2 million more than in FY18, for telehealth.

The bill also would provide $325 million, or $10 million more than in FY18, for children’s hospitals graduate medical education.

Also included is a $2 billion increase, to $39.1 billion, for the National Institutes of Health (NIH), which drew hospital praise.

“The $2 billion increase to the NIH budget builds upon similar increases in recent years, ensuring sustained, predictable growth for medical research funding and helping researchers realize the promise of hope for millions of patients battling life-threatening and chronic diseases,” Darrell G. Kirch, MD, President and CEO of the Association of American Medical College (AAMC), said in a written statement. “This additional funding will also support jobs across the country, bolster local and regional economies, and support America’s global competitiveness in science and technology.”

The bill would provide $3.7 billion to fight opioid abuse, marking a $145 million increase from the current fiscal year. The funding aims to improve treatment and prevention efforts; find alternative pain medications; and address workforce needs, especially in rural communities.

The bill also would provide $1.63 billion for 10,400 Community Health Centers (CHCs), which serve more than 24 million patients. That includes $200 million for CHCs to expand behavioral health and substance use disorder prevention and treatment services.

Additionally, $765 million, or $20 million more than in FY18, would go to healthcare fraud and abuse control.

ACA Provisions

The bill includes no new funding for the Affordable Care Act (ACA), but it does address some ACA policies.

For instance, it continues a provision requiring the Trump administration to operate the ACA risk corridor program in a budget-neutral manner by prohibiting any money from the Labor-HHS appropriations bill from funding it.

The bill also would require the administration to publish ACA-related spending since the law’s inception by category. Additionally, the administration must publish information on the number of employees and contractors and the activities involved in implementing, administering, or enforcing provisions of the ACA.

The Senate vote on the ACA-focused provisions follows an Aug. 9 address by Alex Azar II, secretary of the HHS, blasting the ACA marketplaces and promising changes.

Azar, who was addressing the American Legislative Exchange Council’s meeting in New Orleans, noted that since the ACA marketplaces launched in 2014, premiums in Louisiana have increased by 123 percent.

“It is little surprise that Americans in this market who don’t have access to Obamacare’s generous subsidies are now opting out of the system,” Azar said.

Among changes the Trump administration has pushed are state reinsurance programs, which “can help hold down premiums despite Obamacare’s inherent instability,” Azar said.

“We look forward to offering states all the flexibility possible under the law to craft solutions that promote affordability, fiscal sustainability, private coverage, and consumer choice,” Azar said.

Efforts to provide that flexibility were seen in recently finalized regulations allowing longer access to short-term, limited-duration insurance plans that lack the full range of “essential health benefits” required by the ACA but are 50 to 80 percent cheaper than ACA marketplace plans.

Azar noted some states have subsequently moved to restrict such plans through measures such as limiting the initial contract period to around six months, rather than up to a year as allowed by the federal rules.

“We believe sensible state regulation of these plans is important,” Azar said. “But millions of Americans are in need of affordable insurance options, and states can help build this market outside of Obamacare’s broken regulations.”

Monday, Aug. 13

 “Blue Button 2.0 Developer Conference” hosted by CMS in Washington, D.C. Learn more.

Tuesday, Aug. 14

Webinar by HFMA titled “Moving Toward a Denial-Free Future: Creating a Denial Management and Revenue Recovery Strategy.” Learn more.

Conference call by CMS titled “ESRD Quality Incentive Program: CY 2019 ESRD PPS Proposed Rule.” Learn more.

Webinar sponsored by AHIP titled “HEDIS 2019 Changes: How Technical Specifications Impact You.” Learn more.

Release of the U.S. News & World Report 2018-19 Best Hospitals ranking.

Wednesday, Aug. 15

Conference call by CMS titled “Sharing Federal Strategies to Address the Opioid Epidemic Open Door Forum.” Learn more.

Data submission deadline for hospitals participating in the CMS Hospital Inpatient Quality Reporting Program. Learn more.

Webinar by the American Hospital Association (AHA) titled “Winning the Battle on Disease Production and High-cost Medical Claims.” Learn more.

Annual State Health Policy Conference of the National Academy for State Health Policy (through Aug. 17). Learn more.

Webinar by Lexis Nexis Healthcare titled “The Future of Provider Data Exchange.” Learn more.

Web conference by the Advisory Board titled “The Decision Machine: Analytics and the Rise of AI.” Learn more.

Thursday, Aug. 16

Webinar by CMS titled “From Hospice Item Set Data to Quality Measure.” Learn more.

Webinar by AHA titled “Case Studies in Innovative Patient Engagement.” Learn more.

Webinar sponsored by AHIP titled “The Chicken or the Egg? Genetic Testing Coverage.” Learn more.

Healthcare Documentation Integrity Conference of the Association for Healthcare Documentation Integrity (through Aug. 18). Learn more.

Web conference by the Advisory Board titled “Unpack the 2019 MACRA Proposal.” Learn more.

Friday, Aug. 17

Publication date in the Federal Register of the final rule for FY19 Medicare payment policies and rates under the Inpatient Prospective Payment System and the Long-Term Care Hospital Prospective Payment System. Read the rule.

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