The wide-ranging bill, supported by hospitals, addresses key reimbursement issues created with the passage of the Bipartisan Budget Act of 2015.
The U.S. House has passed on a voice vote sweeping legislation that would, among many things, ease payment restrictions for some outpatient services at hospitals and adjust 30-day readmissions penalties to account for socioeconomic disparities.
The Helping Hospitals Improve Patient Care Act (H.R. 5273) was introduced in May by Health Subcommittee Chairman Pat Tiberi (R-OH) and Health Subcommittee Ranking Member Jim McDermott (D-WA) and is full offset.
Among its several provisions, the bill would:
- Extend for five years the Rural Community Hospital Demonstration Project;
- Create a "mid-build" exception to the current law on increasing the number of beds for long-term care hospitals;
- Modify the treatment of ambulatory surgery center patient encounters for the meaningful use program;
- Delay in CMS authority to terminate contracts for Medicare Advantage plans failing to achieve minimum quality ratings while CMS conducts research and reports on socioeconomic status and quality ratings;
- Require that CMS report Medicare enrollment data by Congressional district;
- Create a "cross walk" of 10 inpatient surgical codes that will be linked to outpatient surgical codes.
Companion legislation is moving through the U.S. Senate.
The Congressional Budget Office estimates that the House bill would cost $50 million from 2017-2021 period but decrease direct spending by $14 million from 2017-2026 period. Pay-as-you-go procedures apply because enacting the legislation would affect direct spending.
The bill has the backing of the American Hospital Association, the Federation of American Hospitals, America's Essential Hospitals, and the Association of American Medical Colleges, all of whom lobbied Congress to act on the measure.
In a letter to House leaders last month, the American Hospital Association said the bill addresses Medicare reimbursement problems created with the passage of the Bipartisan Budget Act of 2015.