This Week in Washington: Senate HELP Committee Chairman requests comments on Long COVID draft proposal; CMS announces proposed Transforming Episode Accountability Model; CMS releases FY2025 Inpatient and Long-Term Care Hospital Prospective Payment System proposed rule.

Congress

House

House Energy and Commerce Committee Subcommittee on Health Holds Hearing on Telehealth Service Proposals

On April 10, the House Energy and Commerce Committee Subcommittee on Health held a hearing to discuss proposals concerning telehealth service access, reimbursement and geographic restrictions. The proposals were:

H.R. 134, To amend Title XVIII of the Social Security Act to remove geographic requirements and expand originating sites for telehealth services: Allows any location in the United States, including a beneficiary’s home, to be considered an originating site for the purpose of furnishing telehealth services under Medicare.

H.R. 1110, KEEP Telehealth Options Act of 2023: Requires the Department of Health and Human Services Secretary (HHS Secretary) to publish a report on the provision of telehealth services under Medicare, Medicaid and the Children’s Health Insurance Program (CHIP) during the COVID-19 emergency and requires the Medicare Payment and Medicaid and CHIP Payment Advisory Commissions to study the risk of fraudulent activities related to the expansion of telehealth.

H.R. 3432, Telemental Health Care Access Act of 2023: Eliminates certain geographic restrictions and in-person Medicare coverage requirements to promote access to mental and behavioral telehealth services.

H.R. 3875, Expanded Telehealth Access Act: Permanently expands practitioner eligibility for payment for telehealth services under Medicare to include physical therapists, speech-language pathologists, audiologists and occupational therapists and assistants.

H.R. 4189, CONNECT for Health Act of 2023: Removes the geographic requirements for telehealth originating sites, expands the scope of originating sites, allows more practitioners to furnish telehealth services and removes geographic restrictions on telehealth services furnished by Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to improve Medicare reimbursement of telehealth services.

H.R. 5541, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act: Temporarily allows authorized healthcare professionals to provide mental health telehealth services across state lines during a declared national emergency.

H.R. 5611, Helping Ensure Access to Local Telehealth (HEALTH) Act of 2023: Allows Medicare coverage of telehealth services to include audio-only communications, implements a permanent payment system for telehealth services furnished by FQHCs and RHCs and eliminates originating site requirements for telehealth services furnished by them.

H.R. 6033, Supporting Patient Education and Knowledge (SPEAK) Act of 2023: Directs the HHS Secretary to convene a task force to assess barriers and develop recommendations to improve access to health information systems for non-English speakers.

H.R. 7149, Equal Access to Specialty Care Everywhere (EASE) Act of 2024: Requires the Center for Medicare and Medicaid Innovation to conduct a pilot program that would assess the impact of furnishing certain specialty healthcare services through telehealth and other remote technologies.

H.R. 7623, the Telehealth Modernization Act of 2024: Makes certain telehealth flexibilities permanent under Medicare by removing geographic restrictions, expanding eligibility for practitioners, retaining the waiver process for modifying telehealth services covered under Medicare, implementing a permanent payment system for telehealth services furnished by RHCs and FQHCs, allowing clinically appropriate use of telehealth for hospice care and home dialysis and allowing the use of audio-only telecommunications technology.

H.R. 7711, Advancing Access to Telehealth Act: Removes Medicare telehealth geographic restrictions, allows the use of audio-only telecommunications technology and eliminates in-person requirements for certain services furnished through telehealth.

H.R. 7858, Telehealth Enhancement for Mental Health Act of 2024: Directs the HHS Secretary to implement a coding modifier to identify telehealth claims for services that are key components of the care process and furnished by non-physician clinicians or support staff.

H.R. 7856, the PREVENT DIABETES Act: Establishes a diabetes prevention program under Medicare and sunsets the Medicare Diabetes Prevention Program Expanded Model.

H.R. 7863, To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program: Requires the HHS Secretary to issue guidance for providers on best practices for furnishing behavioral health services via telehealth to Medicare beneficiaries with limited English proficiency.

H.R. , Hospital Inpatient Services Modernization Act: Extends regulatory flexibilities associated with the Hospital at Home programs to allow acute hospitals to provide certain inpatient services outside of the hospital setting.

For more information, click here.

House Republican Appropriators Announce Subcommittee Assignment Changes

On April 11, House Republican appropriators announced new subcommittee chair assignments, a day after the House Republican Conference elected Rep. Cole (R-OK) to become the next chairman of the House Appropriations Committee. They are:

  • Valadao (R-CA) as Legislative Branch Subcommittee Chairman;
  • Womack (R-AR) as Transportation-HUD Subcommittee Chairman; and
  • Joyce (R-OH) as Financial Services Subcommittee Chairman.

In addition, House Energy and Commerce Committee Chairman Cathy McMorris Rodgers (R-WA) announced changes to the committee’s subcommittee assignments. They include:

  • Pence (R-IN) to join the Subcommittee on Environment, Manufacturing and Critical Materials and to leave the Subcommittee on Innovation, Data and Commerce;
  • Weber (R-TX) to serve as Vice Chair of the Subcommittee on Communications and Technology;
  • Allen (R-GA) to join the Subcommittee on Energy, Climate and Grid Security and to leave the Subcommittee on Innovation, Data and Commerce;
  • Balderson (R-OH) to join the Subcommittee on Health and to leave the Subcommittee on Communications and Technology;
  • Miller-Meeks to join the Subcommittee on Communications and Technology;
  • Obernolte (R-CA) to join the Subcommittee on Innovation, Data and Commerce and to leave the Subcommittee on Environment, Manufacturing and Critical Materials; and
  • James (R-MI) to join the Subcommittee on Innovation, Data and Commerce and the Subcommittee on Environment, Manufacturing and Critical Materials.

Senate

Senate HELP Committee Chairman Requests Comments on Long COVID Draft Proposal

On April 9, Senate Health, Education, Labor and Pensions Committee Chairman Bernie Sanders (I-VT) released a draft proposal concerning Long COVID. The draft proposal would:

  • Provide $1 billion in mandatory funding per year for 10 years to the National Institutes of Health (NIH) to respond to and address Long COVID;
  • Create a centralized coordinating entity for Long COVID research activities at the NIH;
  • Require the NIH to establish a new grant process for clinical trials related to Long COVID;
  • Establish an NIH Long COVID research advisory board and Long COVID database; and
  • Require federal entities to provide continued education and support on Long COVID risks.

The chairman is seeking comments on the proposal. Comments are due by April 23, 2024.

For more information, click here.

Senate Finance Committee Chairman Issues Statement on CMS MA and Part D Final Rule

On April 5, Senate Finance Committee Chairman Ron Wyden (D-OR) issued a statement in response to the release of a Centers of Medicare and Medicaid Services final rule concerning Medicare Advantage (MA) and Part D. The rule contains several policy changes recommended by the chairman.

In his statement, the chairman announced that the rule will strengthen protections against deceptive and high-pressure marketing practices for seniors, prohibit middlemen selling of seniors’ personal information, and ensure that MA plans provide access to mental health professionals.

For more information, click here.

Senate Finance Committee Holds Hearing on Medicare Physician Payment

On April 11, the Senate Finance Committee held a hearing to discuss Medicare physician payment and chronic care coverage. This hearing is considered a step towards considering physician payment reform. Witnesses were:

  • Amol Navathe, MD, Ph.D., Professor of Health Policy and Medicine at the University of Pennsylvania
  • Steven P. Furr, MD, FAAFP, President of the American Academy of Family Physicians
  • Patricia L. Turner, MD, MBA, FACS, Executive Director and Chief Executive Officer at the American College of Surgeons
  • Melanie Matthews, Chief Executive Officer of Physicians of Southwest Washington (PSW)

For more information, click here.

Senate Finance Committee Subcommittee on Health Care Holds Hearing on Federal Health Programs’ SUD Care

On April 9, the Senate Finance Committee Subcommittee on Health Care held a hearing to discuss how substance use disorder care in federal health programs can be improved. Witnesses were:

  • Brendan Saloner, Ph.D., Bloomberg Professor of American Health at the Johns Hopkins University Bloomberg School of Public Health
  • Malcolm Horn, Ph.D., LCSW, MAC, SAP, Chief Behavioral Health Officer at Rimrock Foundation
  • Sarah Bagley, MD, MSc, Associate Professor of Medicine and Pediatrics, Associate Program Director, Grayken Fellow in Addiction Medicine at the Boston Medical Center and Boston University Chobanian and Avedisian School of Medicine
  • Paul J. Christine, MD, Ph.D., Assistant Professor of Medicine at the University of Colorado School of Medicine and Denver Health

For more information, click here.

Preserving Emergency Access in Key Sites Act Introduced

On April 10, Sens. Machin (D-WV) and Capito (R-WV) introduced the Preserving Emergency Access in Key Sites (PEAKS) Act. The legislation would:

  • Allow Critical Access Hospitals (CAHs) in rural, mountainous areas to operate ambulatory services under a special enhanced Medicare payment model;
  • Reimburse CAHs for ambulatory services if there is no other ambulatory base within 15 miles of the facility; and
  • Ensure that a CAH located in a mountainous area does not lose its designation if a new facility is constructed within 15 miles.

A companion bill was introduced in the House by Reps. Miller (R-WV) and Caraveo (D-CO).

For more information, click here.

Welcome Back to the Health Care Workforce Act Introduced

On April 9, Sen. Kaine (D-VA) introduced the Welcome Back to the Health Care Workforce Act. The bill would direct the Health Resources and Services Administration to establish a grant program to:

  • Support communities in local- and state-level partnerships with healthcare organizations to connect internationally educated healthcare professionals with resources they need to enter the healthcare workforce;
  • Address barriers internationally educated healthcare professionals face when trying to enter the healthcare workforce;
  • Assist with obtaining overseas academic or training records and provide support throughout the U.S. licensing and credentialing process;
  • Develop work-force readiness, peer support, mentoring and career counseling opportunities; and
  • Create opportunities to complete prerequisite courses, education training and English-language learning.

For more information, click here.

Read more on healthcare policy in McGuireWoods Consulting’s Washington Healthcare Update.