The following update was provided for our members by Hall Render, NOSORH Legislative Liaison, on September 27, 2017:

Senate Committee Advances HHS Spending Bill

Congress returned in September after their annual August recess. With Fiscal Year (FY) 2017 funding set to expire October 1, Congress and the White House quickly agreed to terms on a three-month continuing resolution (CR) for FY 17 funding. The three-month CR will keep FY ’17 funding levels in place until December 8, 2017. Congress will then most likely pass an Omnibus FY 2018 spending bill sometime before Christmas.

On September 7, the Senate Appropriations committee voted to advance the FY 2018 Labor, HHS, and Education (Labor-HHS) Appropriations Bill. The bill includes $79.4 billion in discretionary funding for HHS, a $1.7 billion increase above FY 2017 and a $4.5 million increase for rural health programs over FY ’17.

Among the highlights to rural health, the committee provided $10 million for State Offices of Rural Health (SORH), which matches the House appropriated number from earlier in the spring. The committee also provided $67.5 million for the Rural Health Outreach program, which is $2 million above the FY ’17 level. $43.6 million was provided for Rural Hospital Flexibility Grants and $9.3 million for the Rural Health Research program.

NOSORH Attends Senate Rural Health Summit

On September 13, NOSORH leadership was in Washington to attend the annual Senate Rural Health Summit.  NOSORH leaders met with and heard from members on the importance of rural health programs. While in Washington, NOSORH leaders also met with the staff director of the Senate Rural Health Caucus to discuss the SORH Reauthorization bill. NOSORH is hoping a stand-alone SORH reauthorization bill will be introduced in the coming months.

House Committee Seeks Information on 340B

Leaders from the House Energy and Commerce Committee are soliciting information from providers regarding the 340B drug discount program. The Committee has asked providers for details on how much savings are received from the 340B program, who the drugs go to, as well as how the savings are used. Earlier this summer, the committee held a 340B oversight hearing where members expressed concern about the rapid growth and lack of oversight in the Health Resources and Services Administration (HRSA) program.  The Committee is intending to use the information to broaden understanding of how program savings are being utilized by covered entities to help patients.

CMS Issues RFI for Innovation Center

On September 20, CMS issued an informal request for information to gather feedback on changing the direction of its CMS Innovation Center. Comments will be received through November 20, 2017 and can be submitted here.

The Innovation Center is interested in testing models in eight focus areas including increased participation in advanced alternative payment models, consumer-directed care and market-based innovation, physician specialty models, prescription drug models, Medicare Advantage innovation models, state-based and local innovation, including Medicaid focused models, mental and behavioral health models and program integrity.

 Energy and Commerce Advances Batch of Health Care Bills

On September 13, the House Energy and Commerce Committee advanced a series of bipartisan, Medicare-related bills. Many were similar to measures included in the Senate Finance Committee’s CHRONIC Care Act. The committee advanced H.R. 1148, the Furthering Access to Stroke Telemedicine Act introduced by Rep. Morgan Griffith (R-VA). This would expand access to Medicare-reimbursed neurological consultations via telemedicine for patients at hospitals or mobile stroke units.

The Committee also advanced the Medicare Civil and Criminal Penalties Act, authored by Reps. Gus Bilirakis (R-FL) and Kathy Castor (D-FL), to update penalties within the Medicare program. Neither penalty has been updated in 20 years. Additionally, the committee advanced legislation (H.R. 3120) introduced by Chairman Michael Burgess (R-TX). The legislation is intended to reduce the volume of future electronic health record-related significant hardship requests. It would amend the Health Information Technology for Economic and Clinical Health Act to remove the mandate that meaningful use standards become more stringent over time.

 Ways and Means Advances Hall Render’s Stark Initiative

On September 13, the House Ways & Means Committee advanced three health care bills, including a revised version of the Stark Administrative Simplification Act of 2017 (H.R. 3726). The bipartisan bill, which passed unanimously, is the product of the coalition of hospitals and health systems created by Hall Render. The new measure was introduced by Reps. Kenny Marchant (R-TX) and Ron Kind (D-WI) and would allow hospitals to pay a fixed fee to CMS for technical violations of the Stark Law and create a new protocol for their resolution by CMS. The revised legislation will now be voted on by the full House and then proceed to the Senate where additional revisions are expected.

 The committee also passed H.R. 3727, introduced by Rep. Diane Black (R-TN), to increase telehealth coverage. Currently, Medicare fee-for-service limits reimbursement to rural medical facilities, and the program only covers some types of remote monitoring. H.R. 3727 is intended to increase telehealth services through Medicare by removing some of the barriers to access. Earlier this year, the Senate Finance Committee passed similar legislation in the Medicare CHRONIC Care Act. Additionally, the committee advanced H.R. 3729, introduced by Reps. Devin Nunes (R-CA) and Terri Sewell (D-AL), to improve and extend add-on payments for Medicare’s ground ambulance transport program.

 Health-Related Bills Introduced this Month

Rep. David Young (R-IA) introduced a bill (H.R. 3817) to amend title XVIII of the Social Security Act to improve the accuracy of geographic adjustment factors under Medicare and to permanently extend certain adjustments to such factors for certain localities.  Senator Chuck Grassley (R-IA) introduced a companion bill in the Senate (S. 1825).

Rep. Richard Hudson (R-NC) introduced a bill (H.R. 3789) to amend Title XVIII of the Social Security Act to provide under the Medicare program for conditions of participation, reporting requirements and a quality program with respect to air ambulance services. 

Rep. Elise Stefanik (R-NY) introduced the Community Health Investment, Modernization, and Excellence Act of 2017 (H.R. 3770). This bipartisan legislation would extend funds for community health centers.

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