Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


House Budget Committee May Consider FY 2015 Budget Resolution

While Senate Budget Committee Chairman Patty Murray (D-WA) has made it known she will forego convening her committee to formulate a budget resolution for fiscal year (FY) 2015, House Budget Committee Chairman Paul Ryan (R-WI) may attempt to gain the Republican votes needed to go forward with a proposal later this spring. Undoubtedly, both the House and Senate are unlikely to change the $1.014 spending cap for FY 2015 as set forth in the most recent budget deal. Although it is reported that Rep. Ryan is looking at revamping welfare program entitlements, it remains to be seen the extent to which any draft in committee will also attack federal health programs, including the Patient Protection and Affordable Care Act (PPACA). Democrats will have a challenge in crafting an alternative, given that the President’s recommendations appear to be dead on arrival in both chambers.

Medicare Physician Payment Reform Looks Iffy

With only a week left before Medicare physician reimbursement levels are cut by 24% under current law, it remains to be seen if the Senate will take up an alternative, S. 2110, to the House-passed legislation containing the five-year elimination of the individual mandate penalty under the PPACA (H.R. 4015, as passed). The Congressional Budget Office (CBO) estimates that S. 2110 will cost an additional $41.8 billion over the House bill’s ten year cost of $138.4 billion before applying the cost offset. The Senate add-ons include the so-called Medicare extenders and other provisions such as ensuring access to podiatric physicians. It is unclear what new sources of revenue or spending offsets the Senate may consider, if the chamber hurries the legislation to a vote this week or next. If a resolution of the issue cannot be fashioned in time, another short-term extension of the current Medicare physician payment regime may become the order of business this week (the House Majority Leader has alerted members to a possible vote this week to address the issue in one way or another). An extension beyond the November elections may be likely if the House and Senate cannot come to a bipartisan agreement on offsets to repeal and replace the Medicare physician sustainable growth rate (SGR) formula.

Bipartisan Medicare Reform Effort Emerges on a Second Issue

The House Ways and Means Chairman and Ranking Member and their counterparts on the Senate Finance Committee unveiled bipartisan/bicameral draft legislation in an attempt to develop satisfactory means to compare quality across post-acute care (PAC) service settings. The “Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014”, is designed to among other things: collect standardized data; improve hospital and PAC discharge planning; and use the information to reform PAC payments (via site-neutral or bundled payments or some other reform), while ensuring continued beneficiary access to the most appropriate setting of care. The sponsors are asking affected parties to provide them with suggestions on how to improve the legislation.

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