WASHINGTON WIRE
July 27, 2007
Issue 141
House Committees Consider CHIP/Medicare
Senate Panel Holds Confirmation Hearing for New CMS Chief
Top Story
House Committees Consider CHIP/Medicare Bill
This week, House Ways and Means and Energy and Commerce Committees Democrats introduced their much-anticipated legislation to reauthorize the State Children's Health Insurance Program (CHIP) and make significant changes to the Medicare and Medicaid programs.
The Children's Health and Medicare Protection ("CHAMP") Act of 2007 would reauthorize SCHIP and invest an additional $50 billion dollars over five years in the program. The bill would also eliminate a scheduled 10 percent Medicare physician payment cut fiscal year (FY) 2008, providing doctors with a 0.5 percent payment bump each year for the next two years.
But the 465-page bill goes well beyond these two primary provisions to address several additional Medicare and Medicaid priorities. For example, the bill would freeze further implementation of Medicare's so-called "75% Rule" on inpatient rehabilitation facilities, which requires that a certain percentage of patients have one of thirteen specified diagnoses in order to maintain its status as an inpatients hospital or unit. Consumers, clinicians and other stakeholders have targeted the 75% Rule as a barrier to access to inpatient rehabilitation facilities and applauded the Committees' freeze of the rule's implementation.
The legislation would also place a moratorium on promulgation of Medicaid regulations that would redefine allowable rehabilitation and school-based services and codifies that adult day health programs are allowable under the program. The President's FY 2008 budget request stated the Administration's intent to issue regulations to restrict such services and disability advocates have been pushing for Congressional intervention.
Although a $0.45 tobacco-tax increase and a nearly $47 billion cut to the Medicare Advantage program pay for much of the cost of the bill, the CHAMP Act would also find savings through cuts to many Medicare provider groups. For example, $2.7 billion would be saved under Medicare by zeroing-out the FY 2008 3.3% payment update to Skilled Nursing Facilities (SNFs) in 2008.
Inpatient Rehabilitation Facilities (IRFs) would also face a reduction in their scheduled 3.3% update, bringing it down to 1% after the first of the year. Additionally, reimbursement for single knee replacements, single hip replacements, and single hip fractures would be reduced for IRFs. In total, $2.4 billion would be cut from this sector.
The bill would also freeze Medicare payments in 2008 for home health agencies and long-term care hospitals. There would also be a moratorium on construction of long term acute care hospitals (LTACH) and an elimination of the 25 percent rule for stand-alone LTACHs.
Late Thursday night the House Ways and Means Committee approved the legislation along party lines. The House Energy and Commerce Committee adjourned late this afternoon without passing the bill. It now seems likely that House leadership will bring the bill to the floor, bypassing Committee approval. House leaders had hoped to pass the bill prior to the August Congressional recess.
The Senate's $35 billion CHIP reauthorization bill, which is funded entirely by an increase in tobacco taxes, includes no Medicare-related provisions. The bill was approved by the Senate Finance Committee last week and the full Senate is expected to begin debate on the measure Monday afternoon. The Bush Administration issued a formal veto threat on the Senate and House legislation today, using a philosophical argument that expansion of CHIP represents a step toward government-run healthcare. It remains very unlikely that Democratic leaders will have the votes to override a veto.
Health Care News
Senate Panel Holds Confirmation Hearing for New CMS Chief
On Wednesday, the Senate Finance Committee held a confirmation hearing for Kerry Weems to be Administrator of the Centers for Medicare and Medicaid Services (CMS).
A 24-year veteran of the Department of Health and Human Services (HHS), Kerry Weems was nominated by the President to head the agency in May. Leslie Norwalk served as Acting Director of CMS until her departure last week.
Weems stated that he would increase oversight of the agency and vowed to be more responsive to Congressional requests. He also assured the Committee that he would not let the agency be used for political purposes, stating that he had resisted political pressure in the past.
Weems received praise from several Committee members - both Republicans and Democrats. While many Members' questions were addressed during the hearing, additional questions were submitted to the nominee. Chairman Baucus (D-MT) stated that once those questions are answered, the Committee will vote on Weems' nomination.
PPSV in the News
On July 27, PPSV Principal Jim Pyles made a presentation on the "Impact of the Supreme Court's Decision in Long Island Care at Home, Ltd. v. Coke on Minimum Wage and Overtime Pay". The presentation was to the Maryland-National Capital Homecare Association. Assisting in the presentation was Jodi Robinson of PPSV.
Upcoming Events
Hearings
Wednesday, August 1, 2007
FDA Tobacco Regulation; Disease Research and Prevention Bills - Markup
Senate Health, Education, Labor and Pensions Committee
9:30 a.m., location TBA
Post-Katrina Health Care
House Energy and Commerce - Subcommittee on Oversight and Investigations
9:30 a.m., 2123 Rayburn
Payment to Small Health Care Providers
House Small Business - Subcommittee on Regulations, Healthcare and Trade
10 a.m., 2360 Rayburn
For More Information
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