Appropriations Process Rolls Along
On May 9, the House Appropriations Committee passed by a vote of 30-23 the annual Labor-HHS spending bill for the upcoming fiscal year. The full-committee passage came two weeks after the House Labor-HHS Appropriations Subcommittee introduced their fiscal year (FY) 2020 spending bill.
As passed by the committee, the bill provides $12,500,000 for the State Offices of Rural Health, a $2.5-million-dollar increase over FY 2019 funding. Also included in the spending bill is $59 million for Medicare Rural Hospital Flexibility Grants and $19,942,000 for the Small Rural Hospital Implementation Grant Program. The next step for the Labor-HHS bill is before the full House of Representatives, which hopes to pass the bill no later than June 27.
The Senate Appropriations Committee has yet to introduce any of their spending bills for FY 20. Senate Appropriations Chairman Richard Shelby (R-AL) has indicated the Senate’s desire to pass a disaster relief bill before embarking on the annual appropriations bills. The Senate and House bills are expected to significantly differ with the House bill having controversial policy riders included in the committee-passed bill.
Funding for FY 2020 expires in 123 days on September 30, 2019.
HELP Committee Leaders Release Draft Bill Targeting Health Care Priorities
Senate Health, Education, Labor, and Pensions (HELP) committee leaders Sen. Lamar Alexander (R-TN) and Sen. Patty Murray (D-WA) released a wide-ranging draft bill addressing health care issues such as surprise medical billing, prescription drug costs, and urgent public health concerns. The proposal is separated into five main sections: approaches to tackling balance or “surprise” medical billing, reducing prescription drug costs, increasing transparency in health care, bolstering public health, and improving the exchange of health IT. According to Sen. Alexander, legislation combining these proposals with ones from the Senate Finance Committee will be marked up this summer with the goal of having it reach the President’s desk by July.
For surprise medical bills, patients would be tasked with paying bills as if they are receiving in-network care when they are unexpectedly treated out-of-network in an emergency situation or at an in-network facility.
The proposal includes several measures addressing public health concerns, including combating vaccine misinformation and maternal mortality. To increase transparency in the health care system, the draft proposes to require plans to maintain updated provider directories. Plans and providers would also be required to give patients estimates of their expected out-of-pocket costs within 48 hours of a request. The draft also contains many drug pricing provisions, such as speeding low-cost generic drugs to market.
The committee is requesting comments on the discussion draft. Comments must be submitted to LowerHealthCareCosts@help.senate.gov by 5 PM on Wednesday, June 5, to be considered. A section-by-section summary can be found here.
Rural Health Bill Introduced this Month
Senators Brian Schatz (D-HI) and Lisa Murkowski (R-AK) introduced the Expanding Capacity for Health Outcomes Act of 2019 (ECHO Act). The bill is intended to increase access to health care services in rural areas by expanding the use of technology-based collaborative learning and capacity building models. The bill builds on findings of the 2016 ECHO Act that was signed into law and required HHS to examine ECHO models and report to Congress.
The ECHO model is an innovative medical education program that uses interactive videoconferencing to link specialist teams with primary care providers in rural areas. The bill, S. 1618, would create a program to provide grants and technical assistance to further develop and evaluate the ECHO model and similar models.
Reps. Mark Green (R-TN) and Bennie Thompson (D-MS) introduced H.R. 2990 to amend title XVIII of the Social Security Act to permit States to designate without any mileage limitations facilities that are located in rural areas as critical access hospitals. The bill would repeal the “35-mile rule” that currently bars hospitals from pursuing a Critical Access Hospital (CAH) designation.
Currently, a rural hospital must be at least 35 miles away from another hospital to receive the CAH designation. If passed, the bill would allow states to designate a facility a CAH if it meets the other requirements: (1) the hospital must have 25 or fewer inpatient beds; (2) must provide 24/7 emergency care services; and (3) the average length of stay for acute care patients must be 96 hours or less.