Health Policy Legislative Update – 10/31/2015


While the House was busy planning for John Boehner’s exit, our representatives still found time to address health care issues. Marilyn Singleton, MD, JD summarizes recent healthcare-related legislative activity on Capitol Hill in this week’s legislative update.

Medicaid Payments and MOC Intersect

On October 1, 2015, S. 2118, the Ensuring Enhanced Access to Primary Care Act was introduced by Sen. Amy Klobuchar (D-MN) and referred to the Senate Finance Committee. Recall that the ACA temporarily raised Medicaid payment rates to encourage physicians to see Medicaid patients. The bill would extend the application of Medicare Part B rates to Medicaid.

The truly interesting facet to the bill is the definition of physicians who are eligible to receive this rate: family medicine, general internal medicine, or pediatric medicine, obstetrics and gynecology, psychiatry or neurology but only if the physician self-attests that the physician is Board certified.

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Attempting to Provide ObamaCare to Illegal Immigrants

On September 30, 2015, H.R. 3659, the Exchange Inclusion for a Healthy America Act of 2015 was introduced by Rep. Luis Gutierrez (D-IL) and referred to the House Energy and Commerce Ways and Means Committees. The bill amends the ACA “to remove citizenship and immigration barriers to access to affordable health care.” The amendments with regard to program eligibility, premium tax credits, cost sharing reductions, pre-existing conditions insurance plan by striking “lawfully present” in the United States, and inserting “who” are in the United States.

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Telemedicine for Veterans

On October 8, 2015, S. 2170, the Veterans E-Health and Telemedicine Support Act of 2015 or the VETS Act of 2015, was introduced by Sen. Joni Ernst (R-IA) and referred to the Senate Veterans’ Affairs Committee. The bill would allow “covered” health care professionals to provide treatment their field via telemedicine in any state. This would apply to “covered” health care professionals providing treatment to patients regardless of whether such health care professional or patient is located in a facility owned by the Federal Government during such treatment.

A “covered” health care professional is one who is authorized by the Secretary to provide health care in the VA system, including a private health care professional who provides such care under a contract entered into with the Secretary; and licensed, registered, or certified in a State to practice the health care profession of the health care professional.

The bill requires a report on the effectiveness of telemedicine in access to care, patient and physician satisfaction, frequency of use, and productivity of providers, and the number and types of telemedicine appointments, and savings (if any) by the VA.

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Adding More Services to Medicare

On October 8, 2015, H.R. 3712, the Improving Access to Mental Health Act was introduced by Rep. Barbara Lee (D-CA) and referred to the House energy and Commerce and Ways and Means Committees. The sister Senate bill, S. 2173 was introduced by Sen. Debbie Stabenow (D-MI) and referred to the Senate Finance Committee. The bill would provide a 10 percent increase in payment for clinical social workers and would pay for such services in addition to clinical psychologists for residents of skilled nursing facilities.

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New Penalties for Medicare Fraud

Of course, dismantling the program itself would be a permanent solution.

On October 8, 2015, H.R. 3718, the Preventing and Reducing Improper Medicare and Medicaid Expenditures to Restore Integrity to Benefits Act of 2015 was introduced by Rep. Peter Roskam (R-IL) and referred to the House Energy and Commerce and Ways and Means Committees. The bill would create incentives for the Medicare administrative contractors, including (1) a sliding scale of award fee payments, (2) substantial reductions in award fee payments under cost-plus-award-fee contracts for those who fail to improve payment accuracy.

The bill also provides for penalties for the illegal distribution of a Medicare, Medicaid, or CHIP beneficiary identification or unique health identifier numbers. This applies to those who purchase, sell or distribute, or arrange for the purchase, sale, or distribution of a beneficiary identification number or unique health identifier for a health care provider. The perpetrators would be subject to up to 10 years imprisonment or up to $500,000 ($1,000,000 in the case of a corporation), or both.

The bill would also implement programs to improve the sharing of date between the federal and state Medicaid programs.

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Enhancing States’ Ability to Regulate Behavior of Abortion Providers

On October 7, 2015, S. 2159, the Women’s Public Health and Safety Act was introduced by Sen. David Vitter (R-LA) and refer to the Senate Finance Committee. The bill creates rules regarding health provides who perform or participate in abortions. A State, at its option, may establish criteria with respect with a State plan under which any person or entity which performs abortions must operate. Exceptions include pregnancies which are the result of rape or incest, or where a woman suffers from a physical disorder, a physical disorder, physical injury, or physical illness that would place the woman in danger of death unless an abortion is performed.

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Expanding Sunshine Rules to Physician Extenders

On October 7, 2015, S. 2153, the Provider Payment Sunshine Act was introduced by Sen. Chuck Grassley (R-IA) and referred to the Senate Finance Committee. The bill would require applicable manufacturers to include physician assistants, nurse practitioners, clinical nurse specialists, certified nurse anesthetists, or certified nurse-midwives (in addition to physicians) in their reports.

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Medical Liability Coverage for Federal Health Clinic Volunteers

On October 7, 2015, S. 2151, the Family Health Care Accessibility Act of 2015 was introduced by Sen. John Thune (R-SD) and referred to the Senate Health, Education, Labor, and Pensions Committee. The bill provides liability protections for volunteers at federal health clinics. Such volunteers would be treated as employees for malpractice insurance purposes.  The clinic must post a clear and conspicuous notice at the site where the service is provided that the legal liability of the health practitioner is limited.

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Government Grants to Encourage Primary Care Physicians

On September 30, 2015, S. 2107, the Building a Health Care Workforce for the Future Act was introduced by Sen. Jack Reed (D-RI) and referred to the Senate Health, Education, Labor, and Pensions Committee. The bill requires the Department of Health and Human Services (HHS) to award matching grants to enable states to implement scholarship programs to ensure an adequate supply of health professionals. The grants would assist medical schools in developing and primary care mentorship programs and encourage students to pursue primary care medicine.

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