Feb 8, 2019
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Hall Render’s This Week in Washington – February 8, 2019

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Senate Lays Groundwork for Pricing Transparency Legislation

A bipartisan group of senators continue to lay the groundwork for the introduction of pricing transparency legislation. On February 5, the senators released a letter seeking information from stakeholders as they prepare to introduce legislation that builds on draft legislation from last Congress.

The effort is being led by Sen. Bill Cassidy (R-LA), who released draft legislation in September 2018 that caps what hospitals can charge insurers for out-of-network emergency department care or when a patient receives care from an out-of-network physician at an in-network hospital. The patient’s share of the medical bill would be limited.

The senators, who along with Cassidy include Sens. Michael Bennett (D-CO), Todd Young (R-IN), Tom Carper (D-DE), Lisa Murkowski (R-AK) and Maggie Hassan (D-NH), asked interested insurers, providers and employers for a response to their comprehensive list of questions by February 18. Among a long list of questions, the letter asks providers to disclose: their average-out-of-network payment for emergency services and how this compares to Medicare and charges by pan type; how often they send a balance bill to patients who see an out-of-network provider at in-network facilities; and the percentage of balance bills over $750.

The Senate’s interest in addressing pricing transparency for medical bills is seen as one of the few areas where significant bipartisan health legislation could advance this Congress. During his State of the Union address on Tuesday, President Trump called for legislation to make insurers and hospitals disclose their prices to help bring down costs and reduce surprise billings. The Senate Health Committee is expected to hold hearings on the issue in the coming months.

ACE Kids Act Reintroduced in Senate

On February 5, Senate Finance Chairman Chuck Grassley (R-IA) reintroduced a bipartisan bill intended to provide states with the option of providing coordinated care for children with complex medical conditions through Medicaid.

The Advancing Care for Exceptional Kids Act is intended to make it possible for home health providers to coordinate care, lower costs and improve quality outcomes for children with complex medical conditions on Medicaid who require specialized care. The bill (S. 317) was referred to the Senate Finance Committee, which has jurisdiction over Medicaid.

HRSA Announces Upcoming Rural Grant Funding Opportunity

On February 4, the Health Resources and Services Administration’s (“HRSA”) Federal Office of Rural Health Policy announced plans to award approximately 75 grants of up to $1 million. The grants would seek to expand opioid and other substance use disorder services in high-risk rural communities. The grant award will cover a three-year period and require awardees to implement a set of core substance and opioid use disorder prevention, treatment and recovery activities that align with HHS’s Five Point Strategy to Combat the opioid crisis.

All domestic public and private entities, nonprofit and for-profit, will be eligible to apply. The services must be provided in a HRSA designated rural area. HRSA intends to release a notice of funding opportunity in the coming weeks.

Next Week in Washington

The House and Senate will gavel back into action on February 11 for a full legislative week with a number of health-related hearings on the schedule. On February 12, the Senate Health Committee will hold a hearing on the opioid crisis. On the same day, the House Ways and Means Committee will hold a hearing on the cost of rising prescription drug prices.

On February 13, the House Energy and Commerce Committee will hold a hearing examining three bills that would reverse Trump administration policies related to the Affordable Care Act (“ACA”). Specifically, the committee will feature H.R. 986, which would overturn the Trump administration’s revised guidance on 1332 waivers. The bill was introduced Wednesday by Energy and Commerce Congresswoman Annie Kuster (D-NH).

Health-Related Bills Introduced This Week

Rep. Lisa Blunt Rochester (D-DE) introduced a bill (H.R. 987) that would amend the ACA and provide for federal exchange outreach and educational opportunities. The bill will be part of the focus of House Energy and Commerce hearings next week.

Sen. Patrick Leahy (D-VT) introduced a bill (S. 340) that is intended to promote competition in the market for drugs by blocking tactics bad drug makers use to delay generic drug development by withholding drug samples. The bill has 27 Senate co-sponsors and has already been placed on the Senate calendar for a vote.

Sen. Bob Menendez (D-NJ) introduced a bill (S. 348) that would amend Title XVIII of the Social Security Act to provide for the distribution of additional residency positions. The bill would increase Medicare-supported doctor training slots by 15,000 and increase the number of GME positions by 3,000 a year for five years.

This Week in Washington History

24 Years Ago: President Bill Clinton delivers the 1995 State of the Union Address. The speech marks the first time a Republican occupies the Speaker of the House chair since 1954. Clinton’s 9,190 word speech still stands as the longest State of the Union Address ever given.

47 Years Ago: President Richard Nixon delivers the 1972 State of the Union Address. In his speech, Nixon tells Congress, “There are more candidates for the Presidency in this Chamber today than there probably have been at any one time in history of the Republic.”

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