President Pleads for Ebola Funding Before Adjournment Sine Die

With the means to extend appropriations for federal spending into next year still undecided, the December 11th expiration of the current continuing resolution (CR) leaves few legislative days for a decision after Congress returns on December 1st. Both House and Senate appropriators still hope to fashion an omnibus bill which would provide funding through the remainder of fiscal year (FY) 2015, but the President’s Executive Order to allow millions of illegal immigrants to remain in the U.S. has placed a large hurdle for House Republican and Senate Democrat appropriators to scale before the end of the lame-duck session. Some House Republicans have expressed interest in providing full year funding for most agencies while only providing very short-term funding for immigration-related agencies that would implement the President’s executive actions on immigration. The President also urged congressional leaders to include $6.2 billion for Ebola efforts in their final spending bill. In this connection, the House Foreign Affairs
Committee did pass H.R. 5710, legislation that would authorize $1.8 billion in emergency aid for the USAID International Disaster Assistance account. Republicans want additional measures to contain the disease in the affected countries and, at a House Energy and Commerce Subcommittee on Oversight hearing, suggested that the Administration institute a travel ban and a mandatory quarantine for patients entering this country. The Senate Health, Education, Labor and Pensions (HELP) Committee helped address the issue by passing S. 2917, legislation that would add Ebola to the FDA priority review voucher program. In the Senate, Senators Rob Portman (R-OH) and Edward Markey (D-MA) introduced legislation that would authorize the U.S. Department of Health and Human Services (HHS) to distribute funds to help hospitals that voluntarily seek designation as an Ebola treatment center. Hospitals could use the funds to train workers, create isolation units, acquire personal protective equipment and care for patients with Ebola or other serious infectious diseases. They are urging congressional leaders to include their provisions in any final spending bill.

Medicare Hospital Improvement for Payment Act Unveiled

Rep. Kevin Brady (R-TX), Chairman of the House Ways and Means Subcommittee on Health released draft legislation, termed the “Hospitals Improvements for Payment (HIP) Act of 2014,” and asked interested parties to provide the committee with their comments. He said that the discussion draft is one element of the committee’s broader effort on comprehensive Medicare reform and that Title I is designed to address the problems associated with Medicare’s two-midnight policy, short inpatient stays, outpatient observation stays, auditing and appeals. He said that Title II includes nineteen different hospital reform suggestions made by other members of the committee. Of note, among other things, the legislation would: establish a hospital prospective payment system (HPPS) by FY 2020 which would aggregate all indirect medical education (IME) and disproportionate share hospital (DSH) payments for short stays into the HPPS base rate; then require that overnight outpatient observation stays are reimbursed by Medicare Part A and subject to the Part A deductible and cost-sharing rules; clarify that outpatient overnight observation stays would count towards SNF eligibility after 3-days; repeal the 0.2% reduction in the IPPS final rule containing the two-midnight standard; reform RAC audit and appeal procedures; repeal the PPACA moratorium on physician owned hospitals; expand the access to Medicare data; provide relief to critical access hospitals; and require HHS to develop a means to further blend payments for outpatient and inpatient services in order to transition to one unified HPPS.

House and Senate Advance Health Legislation

Without dissent, the House passed H.R. 5544, legislation that would authorize research through the Department of Energy to assess the risks associated with low-dose ionizing radiation. Also the Senate passed: H.R. 669, the Sudden Unexpected Death Data Enhancement and Awareness Act; H.R. 4067, legislation that would provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014; and S. Res. 588, a resolution recognizing that access to hospitals and other health care providers for patients in rural areas of the United States is essential to the survival and success of communities in the United States.

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