December 7, 2001

House Approves Medicare Regulatory Reform Legislation

The House of Representatives Dec. 4 passed H.R.3391, the "Medicare Regulatory and Contracting Reform Act of 2001" (MRCRA) under a suspension of the rules. The legislation contains provisions that appeared in the Medicare regulatory relief/reform bills passed by the Energy and Commerce and Ways and Means committees in October (H.R. 2768 and H.R. 3046).

H.R. 3391 eases regulatory burdens placed on Medicare providers, addresses provider rights during audits, and establishes a competitive process for selecting Medicare contractors. It also requests a study of potential flaws in the physician compensation system, including the sustainable growth rate (SGR), and creates a Technical Advisory Group to review Emergency Medical Treatment and Active Labor Act (EMTALA) regulations and advise the HHS Secretary accordingly. In addition, H.R. 3391 allows treating physicians to determine whether EMTALA services are reasonable and necessary based on the information available at the time the care was provided.

The legislation also addresses beneficiary rights, including the creation of a "prior determination process" that informs Medicare beneficiaries of coverage eligibility before receiving certain services. Additionally, H.R. 3391 contains provisions to create a process for requesting exceptions to national coverage decisions.

Several members of the Senate Finance Committee introduced a bipartisan regulatory and contracting reform bill (S.1738) in November [see Washington Highlights, Nov. 30]. However, the Senate bill does not address several issues contained in the House bill (e.g., advance beneficiary notices, E&M guidelines, extrapolation, the EMTALA Task Force, the SGR and other flaws in the current physician compensation system).

Information: Chris Mitchell, AAMC Office of Governmental Relations, 202-828-0526.