Policy Update 12-16-19

Federal Health Care Issues
Although impeachment hearings dominate the national news coverage, there’s been a holiday flurry of activity with federal bills and rules coming out of Washington D.C.

Passing or extending a spending bill that delays disproportionate share hospital (DSH) cuts and funds health care programs: The current short-term 2020 spending bill expires on December 20. If the spending bill is not extended, funding reauthorization for community health centers, national health service corps, Medicare quality programs and special diabetes programs will lose funding. Additionally, DSH cuts will go into effect on January 1, 2020. These cuts will not affect Vermont hospitals in the first year or two due to the fact that the State of Vermont cut a total of $15 million in DSH funding from the FY 2019 and FY 2018 budgets. Congress may pass complete appropriation bills or a short-term spending bill. Either way, they will be looking for a way to fund programs and the delay in DSH cuts.

Surprise billing: The Ways and Means Committee announced on Thursday that they have a bi-partisan agreement on legislation that would protect patients from surprise billing while allowing for a “robust, impartial and structured process” to determine the reimbursement from the insurer to the provider. Uninsured patients will also be able to participate in the process if they were provided misleading cost information by a provider. The proposed bi-partisan agreement also includes an exemption for existing state laws. 

Prescription drug bill: The House of Representatives voted to approve the Lower Prescription Costs Now Act, which would allow the federal government to negotiate prices for up to 250 drugs and limit the price of prescription drugs if prices grow faster than inflation. Rep. Peter Welch has been a driving force behind this bill. The Senate will likely not take the bill up. 

Transparency: Currently, all hospitals post what they charge to a federal website. A federal rule set to go into effect on January 1, 2021 would require hospitals to post negotiated charges for all items and services provided by the hospital. Hospitals will also be required to post 300 common services in a consumer-friendly manner so individuals can easily comparison shop between hospitals.