Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


House Votes to Repeal Cadillac Tax

The House of Representatives voted to repeal the Affordable Care Act’s (ACA) 40 percent excise tax on high-cost employer health insurance plans, known as the “Cadillac Tax,” last week. The Middle Class Health Benefits Tax Repeal Act of 2019 (H.R. 748) was sponsored by Rep. Joe Courtney (D-Conn.) and passed by a vote of 419-6.

E&C Advances Eight Health Bills

The House Energy and Commerce Committee marked up 26 bills last week, including eight proposals to reauthorize public health and Medicare programs, improve drug pricing transparency, provide Medicaid funding for the U.S. territories, and address surprise insurance gaps.

The markup included the following health bills:

  • H.R. 2781, the “Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness for Health Act of 2019” or the "EMPOWER for Health Act of 2019"
  • H.R. 728, the "Title VIII Nursing Workforce Reauthorization Act of 2019"
  • H.R. 1058, the "Autism Collaboration, Accountability, Research, Education and Support Act of 2019" or the "AUTISM Cares Act of 2019"
  • H.R. 2507, the "Newborn Screening Saves Lives Reauthorization Act of 2019"
  • H.R. 776, the "Emergency Medical Services for Children Program Reauthorization Act of 2019"
  • H.R. 2035, the "Lifespan Respite Care Reauthorization Act of 2019"
  • H.R. 2296, the “More Efficient Tools to Realize Information for Consumers Act” or the "METRIC Act"
  • H.R. 2328, the "Reauthorizing and Extending America’s Community Health Act" or the "REACH Act"

The Committee was successful in striking a last minute deal on the No Surprises Act (H.R. 3630), which would protect patients from surprise insurance gaps in cases of emergencies and when procedures are done by an out-of-network provider at an in-network hospital. Under the latest version of the legislation, which was incorporated into H.R. 2328, when a billing dispute arises between a provider and insurer the payment rate would be set based on the in-network median rate for the area in which the service occurred in calendar year 2019 starting in 2021. For subsequent years, the rate would be adjusted over time to allow for inflation. An amendment from Reps. Raul Ruiz (D-Calif.) and Larry Bucshon (R-Ind.) would add a backstop that allows providers to appeal the benchmark payment rate through an independent dispute resolution (IDR) process in some cases. The provider would have to demonstrate that they have not been fairly compensated, and the arbitrator would not be allowed to consider initial billed charges in making a decision. The committee also adopted an amendment from Rep. Ben Ray Lujan (D-N.M.) that would require the U.S. Department of Health and Human Services (HHS) and the Government Accountability Office (GAO) to submit a report to Congress on the costs of providing air ambulance services.

All bills were favorably reported out of committee to the full House by voice vote. The surprise billing legislation is not on the House calendar for consideration this week. The House Education and Labor Committee, which also has jurisdiction over HR 3630, is not expected to mark up the measure before the August recess.

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