Legislative Activity

With the end of the year in sight, Congress remains busy in the health policy arena. Partisan talking points are expected to fly on Tuesday, when Chairman Darrell Issa (R-CA) will chair one of his final hearings in the House Committee on Oversight and Government Reform focused on the Affordable Care Act. Economist Jonathan Gruber, who has been reported as saying the “stupidity of the American voter” aided the White House in passing the health reform law, is expected to appear before the Committee. Marilyn Tavenner, Administrator of the Centers for Medicare and Medicaid Services (CMS), is also expected to testify. Administrator Tavenner will likely be asked about Obamacare implementation issues, including the misreported Obamacare enrollment figures that came to light after the midterm elections.

Washington continues to focus on the global treatment of Ebola. This past week, the Centers for Disease Control and Prevention identified a preliminary list of hospitals that have the resources, capacity, and preparation to treat Ebola patients. President Barack Obama is pressing Congress to authorize $6.2 billion in emergency funding to fight the virus in the United States and abroad. The Senate Committee on Foreign Relations, Subcommittee on African Affairs will also hold a hearing to hear testimony on keys to success for the international response.

Some lawmakers and outside groups are requesting a delay of the ICD-10 coding system implementation, which was originally set for 2013. If this movement gains enough traction, applicable delay language may be attached to a spending bill or other significant legislation.

While a permanent sustainable growth rate (SGR) patch is not expected to be passed before the holidays, such legislation will likely be taken up in the first months of the 114th Congress, before the current patch expires on March 31, 2015.

This Week’s Hearings:

  • Tuesday, December 9: The House Committee on Oversight and Government Reform will hold a hearing titled “Examining Obamacare Transparency Failures.” The House Committee on Energy and Commerce, Subcommittee on Health will hold a hearing titled “Setting Fiscal Priorities.”
  • Wednesday, December 10: The House Committee on Energy and Commerce, Subcommittee on Health will hold a hearing titled “Examining FDA’s Role in the Regulation of Genetically Modified Food Ingredients.” The Senate Committee on Foreign Relations, Subcommittee on African Affairs will hold a hearing titled “The Ebola Epidemic: The Keys to Success for the International Response.”

Regulatory Activity

Accountable Care Organization (ACO) Proposed Rule Released

On Monday, December 1, CMS released the “Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations” Proposed Rule. This proposed rule provides modifications to Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program. The proposed rule makes changes to the current program by: clarifying and establishing new definitions of terms; adding a procedure for ACOs to renew their participation agreements; adding, clarifying, and revising the beneficiary assignment algorithm; expanding the types of beneficiary-identifiable data that would be given to ACOs in reports under the program, as well as simplifying the opt-out process for claims data sharing; and adding or modifying policies to encourage increased participation in risk-based models. Amongst other requests, CMS is soliciting comments from ACOs and other stakeholders on the use of telehealth technologies for the coordination of care for assigned beneficiaries.