On May 17, the House Energy and Commerce Health Subcommittee marked up a package of 17 bills characterized as intending to lower costs and increase transparency across the health care system. The AAMC previously commented on these proposals in a May 3 letter to committee leadership, which expressed the association’s support for addressing pending cuts to the Medicaid disproportionate share hospital (DSH) program while underlining concerns related to so-called site-neutral payment and other hospital policies [refer to Washington Highlights, May 5].
The subcommittee marked up and voted on seven measures, including a manager’s amendment, filed by full committee Chair Cathy McMorris Rodgers (R-Wash.), and six pieces of stand-alone legislation. All seven measures will advance to the full committee for consideration.
McMorris Rodgers’ amendment in the nature of a substitute (AINS), which was agreed to by a voice vote, consisted of 11 bipartisan proposals, including:
Increasing transparency across the health care system: Titles I and II of the AINS would enshrine into law certain Trump-era hospital price transparency regulations, including the requirement that hospitals make public standard charges for 300 shoppable services. In addition, the legislation would implement site-neutral payment policies under Medicare for drugs administered in off-campus hospital outpatient departments. The AINS would further require that each department of a provider include a unique identification number for its services and that hospitals submit additional attestations to the Center for Medicare & Medicaid Services for each of their outpatient departments.
Addressing pending cuts to the Medicaid DSH program: Title II of the AINS includes the AAMC-endorsed Supporting Safety Net Hospitals Act (H.R. 2665), which would eliminate two years’ worth of scheduled cuts to the Medicaid DSH program. Reps. Yvette Clarke (D-N.Y.), Dan Crenshaw (R-Texas), Diana DeGette (D-Colo.), and Michael Burgess, MD, (R-Texas) recently led a bipartisan “Dear Colleague” letter to House leadership in support of this legislation, which garnered over 230 signatures [refer to Washington Highlights, May 19].
Extending funding for discretionary health care programs: The AINS would also extend funding for the National Health Service Corps and Community Health Centers through fiscal year (FY) 2025, as well as extend the Teaching Health Center Graduate Medical Education Program through FY 2029.
The subcommittee agreed to H.R. 3290, introduced by Rep. Larry Bucshon, MD, (R-Ind.), by a roll call vote of 16-12. This legislation would authorize the secretary of the Department of Health and Human Services to audit how covered entities use their 340B Drug Pricing Program savings, as well as require 340B hospitals to report comprehensive financial data. The AAMC has previously expressed concerns with this proposal, which would require covered entities to stratify reporting by child site, thereby imposing a significant administrative burden on hospitals participating in the program.