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.


Senate Passes Endless Frontier Act

The Senate passed the United States Innovation and Competition Act (S. 1260) last week by a vote of 68-32. The bill aims to maintain the nation’s global leadership in relation to U.S. competition with China by investing in science and technology. It is comprised of the Endless Frontier Act introduced by Majority Leader Chuck Schumer (D-N.Y.) and Sen. Todd Young (R-Ind.) packaged with other China-specific legislation. The bill would provide $120 million for programs spanning the National Science Foundation, the Department of Commerce, the Department of Energy, and the National Aeronautics and Space Administration (NASA). It would also create a directorate of technology and innovation at the National Science Foundation. The House of Representatives’ Science Space and Technology Committee is scheduled to mark up the National Science Foundation Reauthorization bill on Tuesday and will include the House Endless Frontier Act (H.R. 2731) as an amendment. Action by the House Science Space and Technology Committee does not necessarily preclude action by other House committees of jurisdiction from taking action in this area and there is the possibility of tying the legislation into an eventual infrastructure package.

AAMC Releases Latest Report on Physician Shortages

The Association of American Medical Colleges has released its annual report containing physician workforce shortage projections. The 2021 update of The Complexities of Physician Supply and Demand: Projections from 2019 to 2034 projects a shortfall of 37,800 to 124,000 physicians by 2034. That shortage includes shortfalls of 17,800 to 48,000 primary care physicians and 21,000 to 77,100 specialists. The report’s data was gathered before the COVID-19 pandemic, which AAMC states only exacerbated the challenges to the nation’s health care system.

Surprise Billing Regulation Sent to OMB for Review

The first rule implementing the No Surprises Act, which prohibits the practice of surprise medical billing, is under review by the Office of Management and Budget (OMB) and due to be released on or before July 1. The regulation is expected to outline the methodology for determining the qualified payment amount (QPA) used to settle payment disputes between insurers and health care providers. It is also expected to contain guidance on informed consent. OMB is required to review the interim final rule -- “Requirements Related to Surprise Billing; Part 1” -- before it can be issued; the U.S. Department of Health and Human Services (HHS) sent the rule to OMB on June 8. Additional rules and regulations will be necessary to establish the law’s independent dispute resolution (IDR) process. The No Surprises Act takes effect on January 1, 2022.

In light of an ongoing dispute over how HHS should interpret the law, a coalition of 49 organizations sent a letter to the administration last week urging HHS to “make the qualifying payment amount, on which patient cost-sharing is based, the primary factor in resolving payment disputes.” A bipartisan group of lawmakers including Sens. Bill Cassidy (R-La.) and Maggie Hassan (D-N.H.) and Reps. Larry Bucshon (R-Ind.) and Raul Ruiz (D-Calif.) recently advised HHS that Congress intended all six factors listed in the law – including provider level of training, teaching status, and prior contracted rates – be given equal weight when determining the payment amount for out-of-network bills. In their letter, the stakeholder coalition also urges HHS to ensure that there are no loopholes created by the implementation of the law’s consent requirements. A separate group of 22 patient organizations also sent a letter last week calling on the administration to ensure the arbitration process does not lead to higher patients costs. They also suggest a comprehensive, well-funded campaign to ensure consumers are aware of their rights under the surprise billing law.

HHS Revises PRF Requirements

The U.S. Department of Health and Human Services (HHS) has issued a revised notice of reporting requirement and reporting timeline for recipients of Provider Relief Fund (PRF) payments. The notice changes the deadline for expending PRF payments to be dependent on the date of when the payment was received. It also expands the amount of time providers have to report information from 30 days to 90 days. The PRF Reporting Portal will open for providers to start submitting information on July 1, 2021. Revised reporting requirements will be applicable to providers who received one or more payments exceeding, in the aggregate, $10,000 during a single Payment Received Period from the PRF General Distributions, Targeted Distributions, and/or Skilled Nursing Facility and Nursing Home Infection Control Distributions.

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