Marilyn Singleton, MD, JD summaries health care related bills introduce in the last week of February 2015.
Affordable Care Act
Congress is still putting forth piecemeal legislation to derail or “improve” the Affordable Care Act.
On February 23, 2015, S. 531, Removing Limitations on Insurance Effectiveness and Flexibility Act of 2015 (the “ReLIEF Act) was introduced by Sen. Jeff Flake (R-AZ) and referred to the Senate Finance Committee. The bill would permit health insurance issuers to offer additional plan options to individuals and allow catastrophic plans to satisfy the individual mandate requirement.
On February 27, 2015, H.R. 1185, the Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2015 was introduced by Rep. Steve Stivers (R-OH) and referred to the House Ways and Means Committee. The bill would increase the annual maximum contribution to Flexible Spending Accounts from $2,500 to $5,000 with an additional $500 per each additional employee dependent above two dependents and allow unused benefits to be carried forward.
On February 27, 2015, H.R. 1169, the Health Savings Account Act was introduced by Rep. Jeff Fortenberry (R-NE) and referred to the House Ways and Means Committee. This bill would amend the Internal Revenue Code of 1986 to increase the maximum contribution limit for health savings accounts.
Improving Medicare for Beneficiaries
On February 24, 2015, S. 539, the Medicare Access to Rehabilitation Services Act of 2015 was introduced by Sen. Benjamin Cardin (D-MD) and referred to the Senate Finance Committee. This bill would repeal the Medicare outpatient rehabilitation therapy caps.
On February 26, 2015, S. 578, the Home Health Care Planning Improvement Act of 2015 was introduced by Sen. Susan Collins (R-ME) and referred to the Senate Finance Committee. The bill would revise Medicare’s conditions of and limitations on payment for home health care services. Currently, a physician must certify these services. It would allow payment for home health services to Medicare beneficiaries by: (1) a nurse practitioner, (2) a clinical nurse specialist working in collaboration with a physician in accordance with state law, (3) a certified nurse-midwife, or (4) a physician assistant under a physician’s supervision.
On February 26, 2015, H.R. 1116, the Medicare Audiology Services Enhancement Act of 2015 was introduced by Rep. Gus Bilirakis (R-FL) and referred to the House Energy and Commerce and Ways and Means Committees. This bill would have Medicare cover the following audiology services: (A) Hearing and balance assessment; (B) Auditory treatment services, including auditory processing and auditory rehabilitation treatment; (C) Vestibular treatment; (D) Intraoperative neurophysiologic monitoring.
Medicare Fraud Prevention
This new bill is the culmination of bipartisan efforts to curb Medicare fraud and abuse. Of course, the best way to curb abuse is to have direct payment to the physician and leave out the middlemen.
On February 24, 2015, H.R. 1021, the Protecting the Integrity of Medicare Act of 2015 (PIMA) was introduced by Rep. Kevin Brady (R-TX) and referred to the House Energy and Commerce and Ways and Means Committees. PIMA would amend the Social Security Act to prevent Medicare fraud by several methods, including but not limited to:
(1) Prohibit Social Security account numbers (or any derivative) from being displayed, coded, or embedded on the Medicare card;
(2) Ensure that Medicare payment is not made for items and services furnished to an individual incarcerated, deceased, or otherwise ineligible and not lawfully present in the United States.
(3) If cost-effective and technologically viable, implement use of electronic Medicare beneficiary and provider cards.
(4) Extend the Medicare durable medical equipment face-to-face encounter documentation requirement to include physician assistants, practitioners, or specialists as well as physicians.
(5) Require each Medicare administrative contractor to establish an improper payment outreach and education program for service providers and suppliers.
(6) Encourage greater participation by individuals to report fraud and abuse in the Medicare program through HIPAA’s incentive program.
(7) Requires a valid prescriber National Provider Identifier fro claims for prescription drugs.
(8) Give Medicare beneficiaries the option to receive the Medicare Summary Notice (explanation of benefits) electronically.
(9) Instruct Congress to explore ways to amend existing Medicare fraud and abuse laws and regulations to permit gainsharing or similar arrangements between physicians and hospitals that would otherwise be subject to penalties.