AMERICAN HOSPITAL ASSOCIATION for AMERICAN HOSPITAL ASSOCIATION

Health Issues HCR

Support HR 1763/ S 348, Resident Physician Shortage Reduction Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose HR 506,Hospital Competition Act of 2019, a bill to amend title XVIII of the Social Security Act to increase hospital competition; Statement submitted to the House Judiciary on the hearing "Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Health Care Markets";Letter of support for the Senate Workgroups efforts to ensure consumer protections by addressing surprise medical bills and comments on the development of legislation to protect patients from surprise medical bills; Letter urging Congress and the Administration to take further action to help reduce input and administrative costs, as well as maximize the number of insured patients; Comment letter urged CMS to extend the comment period for the proposed rules related to interoperability provisions of the 21st Century Cures Act by at least 30 days; Comment letter on the Food and Drug Administrations (FDA) draft guidance on blood glucose monitoring test systems (BGMS) for prescription point-of-care (POC) use and urge FDA to consider compiling a finite list of universally acceptable disinfectant products that would apply to all medical devices or classes of device; Comment letter that urged CMS to address the substantial flaws in the star ratings methodology since the ratings inception in 2016 and to suspend the display of overall star ratings on Hospital Compare while the agency continues its important work of enhancing the validity and meaningfulness of star ratings; Comment letter to FDA on the public meeting, Identifying the Root Causes of Drug Shortages and Finding Enduring Solutions with the following legislative recommendations: Strengthen manufacturers drug shortage disclosure requirements, Incentivize manufacturing contingency plans and/or redundancies, Enhance production transparency requirements, Enact shortage disclosure notification requirements for certain medical devices needed to administer drugs, Assess drug shortages as a national security threat, Include potential risk for drug shortages as a factor in the Federal Trade Commission (FTC) reviews of drug company merger proposals, and regulatory recommendations: Establish incentives to encourage manufacturers to produce drugs in shortage, Prevent manufacturing shutdowns, Establish a quality manufacturing initiative, Enhance information on the quality of outsourcing facilities compounding, Expand and improve the FDAs drug shortages list, Develop a list of critical drugs, Consider how reducing the number of unapproved drugs1 on the market might impact shortages, Reduce drug waste, Create an Office of Clinical Affairs within the Drug Enforcement Administration (DEA); Comment letter urging the CMS to use its upcoming proposed rules for Inpatient Rehabilitation Facility (IRF) and other post-acute care providers to address several issues related to the implementation of the revised case-mix grouping (CMG) policies.

Contacted: HOUSE OF REPRESENTATIVES; Internal Revenue Service (IRS); Justice, Dept of (DOJ); Office of Management & Budget (OMB); Health & Human Services, Dept of (HHS); Federal Trade Commission (FTC); Centers For Medicare and Medicaid Services (CMS); Veterans Affairs, Dept of (VA); SENATE; White House Office

Bills named: H.R. 1763 (116th), H.R. 506 (116th)

Taxation/Internal Revenue Code TAX

Monitoring the Tax Cuts and Jobs Act, legislation to overhaul the nations tax code that contains several notable provisions affecting hospitals; Individual Mandate, Access to Tax-exempt Bond Financing, Interest Deduction for Debt, Medical Expense Deductions, Executive Compensation.

Contacted: Veterans Affairs, Dept of (VA); White House Office; Office of Management & Budget (OMB); HOUSE OF REPRESENTATIVES; Federal Trade Commission (FTC); SENATE; Internal Revenue Service (IRS); Justice, Dept of (DOJ); Health & Human Services, Dept of (HHS); Centers For Medicare and Medicaid Services (CMS)

Medicare/Medicaid MMM

Discussions on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussions about the work of Aligning for Health to address social determinants of health; Support HR 1041 / S 586,Critical Access Hospital Relief Act of 2019, a bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services; Support S 895, Rural Hospital Regulatory Relief Act of 2019, a bill to provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals; Support S 948,Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities, and for other purposes; Discussions in support of the Rural Emergency Medical Center Act (REACH) Act; Support for extension of the Rural Community Hospital Demonstration Program; Support for extension of the Frontier Community Health Integration Project Demonstration program; Discuss changes with House and Senate committees to Section 8122 of the SUPPORT for Patients and Communities Act; Letter of support to Energy and Commerce Committee for the hearing on legislation to strengthen our health care system and ACA market stability; Letter urging the Centers for Medicare & Medicaid Services (CMS)to consider alternative payment solutions for Chimeric Antigen Receptor T-cell (CAR T) therapy; Joint letter urging Congress to delay the start of the Medicaid disproportionate share hospital (DSH) cuts, which are scheduled to begin in fiscal year (FY) 2020; Comments to CMS on exploring ways continually to improve the Medicaid managed care program to ensure access to high-quality care for the Medicaid population.

Contacted: Federal Trade Commission (FTC); Office of Management & Budget (OMB); Justice, Dept of (DOJ); Veterans Affairs, Dept of (VA); HOUSE OF REPRESENTATIVES; White House Office; SENATE; Health & Human Services, Dept of (HHS); Internal Revenue Service (IRS); Centers For Medicare and Medicaid Services (CMS)

Bills named: H.R. 1041 (116th)

Budget/Appropriations BUD

Continue to monitor the FY 2019 budget to prevent or minimize hospital cuts.

Contacted: Internal Revenue Service (IRS); White House Office; Office of Management & Budget (OMB); SENATE; Health & Human Services, Dept of (HHS); Justice, Dept of (DOJ); Federal Trade Commission (FTC); Veterans Affairs, Dept of (VA); HOUSE OF REPRESENTATIVES; Centers For Medicare and Medicaid Services (CMS)

Law Enforcement/Crime/Criminal Justice LAW

Meeting with CMS and HHS OIG to relate continuing methodological issues and other errors with the OIG audits targeting hospitals for potential Medicare overpayments and to urge significant reforms of the auditing process including discontinuing use of extrapolation; Discussions on the work/fixes to the anti-kickback provisions in the Eliminating Kickback in Recovery Act of 2018.

Contacted: Justice, Dept of (DOJ); Federal Trade Commission (FTC); Health & Human Services, Dept of (HHS); Internal Revenue Service (IRS); Office of Management & Budget (OMB); White House Office; HOUSE OF REPRESENTATIVES; Veterans Affairs, Dept of (VA); Centers For Medicare and Medicaid Services (CMS); SENATE