POLICY BRIEFINGS


Ways and Means Advances Health Legislation


The House Ways and Means Committee considered changes to Medicare Advantage (MA) plans and repeal of several Affordable Care Act (ACA) provisions on Tuesday. The Committee voted 25-14 to repeal the ACA’s 2.3 percent tax on medical device manufacturers, which helps to fund the 2010 health care law. Rep. Ron Kind (D-Wis.), the lead Democrat cosponsor, was the only Democrat to vote in favor of repeal. Opponents of the tax claim that it stifles industry innovation. During the markup, many Democrats criticized their Republican colleagues for failing to offset the repeal, which would cost $26 billion over the next decade. The markup also included consideration of another Republican priority for changing the ACA, the repeal of the cost-cutting panel known as the Independent Payment Advisory Board (IPAB). Members of
IPAB are appointed by the President and confirmed by the Senate, and are charged with making cuts to Medicare should program spending rise above a certain level. IPAB repeal was unanimously supported by committee Republicans, who were joined by seven Democrats in voting to advance the legislation. Ways and Means also advanced six bipartisan bills dealing with the MA program. These bills address coverage transparency, plan termination, rate scheduling, risk adjustment modifications, and a value based insurance demonstration. Finally, the Committee considered a measure to adjust the Medicare long-term hospital moratorium, a bill dealing with Medicare access for eye tracking accessories for speech generating devices, and an adjustment to a home medical practice demonstration program. The bills are scheduled for consideration on the House floor during the week of June 15. House Majority Whip Kevin McCarthy (R-Calif.) announced that this entire week will be focused on health care, with the possibility of also bringing the 21st Century Cures Act to the floor.


GAO Releases Report on Medicare Administrative Contractors


The Centers for Medicare and Medicaid Services (CMS) should consider whether alternative approaches could enhance contractor performance, according to a report released by the Government Accountability Office (GAO) last week. The GAO found that without using the wealth of data CMS has collected since the implementation of contracting reform in 2006 to analyze other contracting approaches, the agency may be missing opportunities to increase Medicare Administrative Contractors’ (MAC) efficiency and effectiveness. In its comments, the U.S. Department of Health and Human Services (HHS) agreed with this recommendation and expressed plans to analyze alternative contracting approaches for MACs.


Senate Finance Advances Medicare Appeals Process Reform


The Senate Finance Committee voted to advance bipartisan legislation to reform the Medicare audit and appeals process, which identifies waste and fraud in the program. The aim of the Audit and Appeal Fairness, Integrity, and Reforms in Medicare (AFIRM) Act of 2015 is to reduce the growing backlog of appeals by creating additional oversight and new ways to expedient cases through the system. The measure would increase coordination between the Centers for Medicare and Medicaid Services (CMS) and audit contractors, and would require CMS to come up with incentives to ensure auditor accuracy. The bill would also allow for multiple pending claims with similar issues to be settled jointly. An independent Ombudsman for Medicare Reviews and Appeals would assist in resolving complaints about the process, and the Office of Medicare Hearings and Appeals would be provided with additional resources to conduct reviews, hearings, appeals, and to establish new decision-making positions. The Office of Medicare Hearings and Appeals currently receives more appeals every month than it can handle in a year, resulting in a backlog of appeals and wait times of up to two years.



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