The House Energy and Commerce Committee held a July 17 markup to advance legislation regarding several key health care issues, including Medicaid Disproportionate Share Hospital (DSH) payments, the Patient-Centered Outcomes Research Institute (PCORI), and the Title VII health professions workforce development programs. Additionally, the committee passed an amended version of its proposal to address surprise medical bills.
In a July 17 statement following the markup, AAMC Executive Vice President Atul Grover, MD, PhD, characterized the markup as “an important step forward today on numerous bipartisan priorities in support of patients.” Specifically, the AAMC praised the committee for repealing the scheduled Medicaid DSH cuts for fiscal years (FYs) 2020 and 2021, reauthorizing and extending the National Health Service Corps for four years, and investing in the Teaching Health Center Graduate Medical Education program for an additional four years.
The committee also advanced a policy previously approved by the Health Subcommittee to extend PCORI and its funding mechanism for three years through FY 2022 [see Washington Highlights, July 12]. The AAMC expressed appreciation for the committee’s efforts to continue PCORI and noted, “we hope to continue working with lawmakers to secure a full 10-year renewal of the institute’s important work.” The House Ways and Means Committee approved a 7-year reauthorization of the institute (H.R. 3439) June 26 [see Washington Highlights, June 28].
Prior to the markup, AAMC Chief Public Policy Officer Karen Fisher submitted a letter to Chairman Frank Pallone (D-N.J.) and Ranking Member Greg Walden (R-Ore.) expressing support for several of the provisions. However, the letter also highlighted concerns with the No Surprises Act, legislation intended to address surprise billing. While the AAMC strongly supports taking patients out of the middle in surprise billing situations, the letter asks the committee to reconsider the policy passed by the Health Subcommittee to use benchmark rate setting to resolve surprise billing disputes.
The AAMC expressed concern that statutory rate setting will lead to narrow networks, which “stands to potentially limit beneficiary access to academic medical centers due to the higher mission-related costs of care at many of these facilities, without recognizing the higher quality.” Instead, the AAMC urged the committee to explore other options for resolving disputes between payers and providers, including independent dispute resolution or arbitration.
In response to these concerns and others raised by several members of Congress and additional stakeholders, the committee passed a version of the No Surprises Act that was amended by Reps. Raul Ruiz (D-Calif.) and Larry Bucshon, MD (R-Ind.) to include an appeals provision. The amended version allows providers and insurers who are unsatisfied with the benchmark rate to enter into an independent dispute resolution process for claims over $1,250, and for complex cases.
In its statement, the AAMC noted its appreciation to the committee for including an independent dispute resolution option and offered “to continue this dialogue to ensure that the final legislation fully avoids any unintended consequences that could result from setting payment rates in statute.”
The Committee also passed legislation (H.R. 2328) that would reauthorize and extend mandatory funding for the National Health Service Corps, Teaching Health Centers, and Community Health Centers at their current funding levels for four years, and the AAMC-endorsed EMPOWER for Health Act (H.R. 2781) that would reauthorize the Health Resources and Services Administration’s Title VII health professions workforce development programs at increased levels for five years [see Washington Highlights, July 12].