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From Health Law Daily, June 26, 2015

A new era of cooperation? Senate Finance Committee approves 12 health care bills

By Michelle L. Oxman, J.D., LL.M.

The Senate Finance Committee gave the green light to a dozen bills related to Medicare and Medicaid payment issues at an open executive session on June 24, 2015. The committee’s action brings to 36 the number of bipartisan bills it has approved during the 114th Congress.

NOTICE to patients. The bill that would most directly affect patients is S. 1349, the Notice of Observation, Treatment, and Implications for Care Eligibility (NOTICE) Act, which addresses the problem of hospitals furnishing “observation” services to patients on an outpatient basis for two or more days at a time. Because of the 20 percent copayment for Part B services, a patient may pay more for a three-day hospital stay in observation status than or the same services received as an inpatient. In addition, a patient who spends three or more days in the hospital as an inpatient is eligible for skilled nursing services post-discharge. When much or all of the time is billed as outpatient services, the patient’s time in the hospital does not count toward eligibility for further services. The bill would require hospitals to provide written notice to the patient of the observation status and its consequences for cost sharing and eligibility for further services. The notice would be required within 36 hours of beginning observation services or at discharge, whichever occurs earlier.

EHR incentive payments. S. 1347, the Electronic Health Fairness Act, would exclude physician visits in ambulatory surgical centers (ASCs) from the count of visits that must occur at a location equipped with certified electronic health records (EHR) technology to qualify for EHR incentive payments. The justification for this bill is that no EHR systems have been developed for ASCs because they were not mentioned in the original legislation or rules.

Improper payments. S. 861, the Preventing and Reducing Improper Medicare and Medicaid Expenditures (PRIME) Act, would allow the HHS Secretary to hire more program integrity staff rather than hiring contractors for some functions. The bill also would establish incentives for Medicare Administrative contractors to reduce their error rates using both positive incentives and penalties for failure to accomplish error reduction goals.

The Committee also approved:

  • S. 607, which would extend the rural hospital demonstration for five years;

  • S. 1461, which would delay the enforcement of the requirement for direct supervision of therapy through the end of 2015;

  • S. 313, the Prevent Interruptions in Physical Therapy Act, which would allow physical therapists to bill for the services of substitutes as physicians do for “locum tenens” services;

  • S. 1253, to require Medicare payment for disposable devices used to provide negative pressure therapy for pressure wounds; and

  • S. 599, to extend the Medicaid emergency psychiatric care demonstration and allow publicly owned institutions for mental diseases to participate.

MainStory: TopStory FederalLegislationNews PartBNews EHRNews PhysicianNews

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