AMERICAN HOSPITAL ASSOCIATION for AMERICAN HOSPITAL ASSOCIATION

Medicare/Medicaid MMM

Hill outreach to oppose site-neutral payment cuts; Hill outreach in support of the Acute Hospital Care at Home program; Hill outreach about streamlining prior authorization in Medicare Advantage plans; AHA Letter Comments on Medicare Payment Advisory Commission 2024 Payment Proposals; Support S. 803, Save Rural Hospitals Act of 2023, a bill to amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments; Letter comments on three topics that were discussed during the March 2023 Medicare Payment Advisory Commission (MedPAC) public meeting: the hospital wage index, alignment of payment rates across ambulatory settings and Medicare Part B drug payments. Agrees that the current wage index system is flawed, but continues to have concerns about the use of non-hospital data in an alternative wage index system; recommends that the commission reject modifications to the current average sales price (ASP)-plus-6% methodology; and urges the commission not to recommend additional site-neutral payment cuts; Support HR 2665, Supporting Safety Net Hospitals Act, a bill to amend title XIX of the Social Security Act to delay certain disproportionate share hospital payment reductions under the Medicaid program; Comment letter to CMS opposes the proposal to limit the inclusion of patient days for patients who are regarded as eligible for Medicaid benefits under a Section 1115 demonstration project for purposes of the Medicare DSH calculation; Comment letter to CMS regarding a proposed rule to improve access, quality and health outcomes for Medicaid programs and the proposed policies related to access, finance and quality in Medicaid and CHIP managed care programs; Support H.R. 4968 GOLD Card Act of 2023A bill to amend title XVIII of the Social Security Act to exempt qualifying physicians from prior authorization requirements under Medicare Advantage plans, and for other purposes; Support H.R.5378 Lower Costs, More Transparency Act A bill to promote price transparency in the health care sector, and for other purposes; A comment letter on the Centers for Medicare & Medicaid Services (CMS) hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system proposed rule for calendar year (CY) 2024, The letter urges CMS to examine ways to account for these increased costs to ensure that beneficiaries continue to have access to quality outpatient care. It also urges the agency to reduce the productivity cut for CY 2024 as such a cut does not align with hospital and health systems public health emergency (PHE) experiences related to actual losses in productivity during the COVID-19 pandemic; Hill outreach to oppose the elimination of facility fees; Hill outreach to oppose changes that would prevent providers from negotiating contracting restrictions with commercial health insurance plans; A request letter on the Centers for Medicare & Medicaid Services (CMS) to permanently remove the regulatory waivers which ensure hospitals and health systems could leverage telehealth services to respond to a wave of unprecedented need efficiently and effectively; Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, A letter to comment on the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act; A letter to express concerns regarding CMS proposed restrictions on states use of provider-based funding sources, such as provider taxes, to finance Medicaid payments; A letter to CMS requesting that the agency correct an error in its CY 2024 final rule reimbursement rate for hyperbaric oxygen therapy (HBOT) (HCPCS code G0277)

Contacted: SENATE; Centers For Medicare and Medicaid Services (CMS); Health & Human Services, Dept of (HHS); HOUSE OF REPRESENTATIVES; Medicare Payment Advisory Commission (MedPAC)

Bills named: H.R. 4968 (118th), H.R. 2665 (118th), S. 803 (118th), H.R. 5378 (118th)

Health Issues HCR

Discussion with OMB/OIRA regarding OSHA Occupational Exposure to COVID-19 in Healthcare Settings Final Rule; Discussion with FDA Drug Shortage expert regarding Inflation Reduction Act Provisions that could impact duration of shortages; Discussion with ASPR Hospital Preparedness Program Staff about speaking at a meeting regarding HPP issues; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Inpatient Prospective Payment System/Long Term Care Hospital Proposed Rule; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Medicare Advantage Final Rule; Hill outreach about reducing hospital workplace violence; Hill outreach about the benefits of hospital mergers and acquisitions; Hill outreach about the anticompetitive behaviors of travel nurse staffing agencies; Statement to the U.S. Senate Committee on Health, Education, Labor, and Pensions, Examining Health Care Workforce Shortages: Where Do We Go from Here?; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an Request For Information on the reauthorization of the Pandemic and All-Hazards Preparedness Act; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an RFI on the drivers of health care workforce shortages; Support S.1110, Rural Hospitals Support Act, a bill to amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; Support H.R. 1110Telehealth Option Act, a bill to direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Childrens Health Insurance programs during the COVID-19 emergency; Feedback on the Connect for Health Act; AHA provided feedback on the creating opportunities new for necessary and effective care technologies (CONNECT) Act; False Claims Act Case AHA Provides Statement for House Hearing on Price Transparency, Competition; Oppose H.R.977/S.470 Patient Access Higher Quality Health Care Act, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support S.940, The Rural America Health Corps Act A bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Support the Conrad State 30 and Physician Access Reauthorization Act that would allow international doctors trained in the United States to remain in the country if they practice in areas experiencing medical shortages; Letter to CMS regarding intent to issue staffing mandates for nursing homes and urged CMS and policy makers to focus on efforts that will bolster our workforce; Support HR 2389/ S 1302, Resident Physician Shortage Reduction Act of 2023, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Support HR 2411/ S 1150, National Nursing Workforce Center Act of 2023, a bill to amend the Public Health Service Act to support and stabilize the existing nursing workforce, establish programs to increase the number of nurses; Support HR 2534, Preserving Rules Ordered for The Entities Covered Through 340B Act of 2023 or the PROTECT 340B Act of 2023, a bill to amend title XXVII of the Public Health Service Act to ensure the equitable treatment of covered entities and pharmacies participating in the 340B drug discount program; Support HR 2559, Strengthening Community Care Act of 2023, a bill to extend funding for community health centers and the National Health Service Corp; Support HR 2584/S.2768, Safety From Violence for Healthcare Employees Act or the SAVE Act, a bill to protect hospital personnel from violence, and for other purpose; Statement to the House Education and the Workforce Subcommittee on Health, Employment, Labor, and Pensions hearing titled, Competition and Transparency: The Pathway Forward for a Stronger Health Care Market highlighting that mergers and acquisitions can be a helpful tool for many hospitals and pushing back against site-neutral payment policies; Letter urging Congress to continue to protect this critical program and oppose efforts to cut its benefits, which would result in reduced access to quality care for the patients and communities served by 340B hospitals; Statement to Subcommittee on Health of the Committee on Energy and Commerce on its hearing Examining Existing Federal Programs to Build a Stronger Health Workforce and Improve Primary Care; Support S 1447, Bipartisan Solution to Cyclical Violence Act of 2023, a bill to amend the Public Health Service Act to establish a grant program supporting trauma center violence intervention and violence prevention programs, and for other purposes; Support HR 3046/ S 1403, Medical Student Education Authorization Act of 2023, a bill to amend the Public Health Service Act to establish a grant program to award grants to accredited public institutions of higher education, and for other purposes; Concerns with HR 2691, Transparent Prices Required to Inform Consumer and Employers Act or the Transparent PRICE Act, a bill to promote hospital and insurer price transparency; Letter strongly opposing the draft bills, which would create additional site-neutral payment cuts and threaten access to care, especially in rural and other vulnerable communities; Comment letter to the Office of Civil Rights on its HIPAA Privacy Rule to Support Reproductive Health Care Privacy and concerns the guidance is too broad and will result in significant adverse consequences for hospitals, patients and the public at large; Statement to SFC for the hearing on Consolidation and Corporate Ownership in Health Care: Trends and Impacts on Access, Quality, and Costs; Comment letters to CMS on their Inpatient and Long-term Care Facility Prospective Payment System FY 2024 proposed rule; Letter to reauthorize key programs within the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act of 2018, we encourage you to consider policies that will reduce barriers to receiving and administering behavioral health care by improving payment policies, reducing unnecessary regulatory and administrative burden, and strengthening the behavioral health workforce; Comment letter on the Environmental Protection Agencys (EPA) proposed standards for the use of ethylene oxide (EtO) to sterilize medical devices urge caution and thoughtfulness in EPAs approach to avoid disrupting health care delivery through the unintentional fracturing of the already fragile medical device supply chain; Hill briefing, Site-neutral Payment Proposals Would Jeopardize Access to Care for Patients and Communities; Comment on Energy and Commerce Committee Chair Rodgers drug shortages discussion draft; Support S. 2364 Mapping Americas Pharmaceutical Supply Act A bill to map the United States pharmaceutical supply chain and use data analytics to identify supply chain vulnerabilities and other national security threats; Support S. 2510 RAPID Reserve Act A bill to improve supply chain resiliency for critical drug products with vulnerable supply chains and ensure that reserves of critical drugs and active pharmaceutical ingredients are maintained to prevent supply disruptions in the event of drug shortages or public health emergencies; Support S. 1961Pharmaceutical Supply Chain Risk Assessment Act of 2023A bill to require an interagency risk assessment of the pharmaceutical supply chain to identify and mitigate health and national security risks, and for other purposes; Drug Shortage Prevention Act Letter to express support for the Drug Shortage Prevention Act that will help pave the way for additional improvements to the U.S. drug supply chain, which will, in turn, improve patient access and care; Bipartisan request for information on the critically important 340B Drug Pricing Program Letter on the savings 340B hospitals achieve through purchasing certain outpatient drugs at a discount allow them to provide a range of programs and services that directly benefit their patients; Support S.1636/H.R. 3440 Protecting Rural Telehealth Access Act A bill to amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program. Drug Shortages RFI Letter to the U.S. Senate Committee on Energy and Commerce and Finance in response to a Request For Information on drug shortages; Support H.R. 4713 Rural Hospital Technical Assistance Program Act A letter to support HR 4713, the Rural Hospital Technical Assistant Program Act. A bill to make permanent a program that provides technical assistance for rural hospitals to help prevent closures; Verbal Support Train More Nurse Act It instructs HHS and DOL to conduct a joint review of all grant programs supporting the nursing workforce and coming up with recommendations to Congress within a year on how to change the programs to increase nurse faculty, provide pathways for those who want to become nurse faculty, and increase the nursing pipeline for both RNs and LPNs; Support H.R.2412 Helping Kids Cope Act To amend the Public Health Service Act to authorize grants to increase national capacity to provide pediatric behavioral health services at childrens hospitals and through community-based providers to improve childrens access to care; and to authorize grants to begin to address large numbers of children boarding in emergency departments, to support the pediatric behavioral health workforce, and for other purposes; Meeting with OMB to discuss Proposed Minimum Staffing Requirements for Long-term Care Facilities; Meeting with OMB to discuss FY 2024 IPPS and LTCH Final Rule; Meeting with Senate Finance Committee regarding the FY 2024 LTCH Final Rule; A letter to comment on ways to improve access to care in rural and underserved areas ensuring that Americans in these rural and underserved areas have high-quality, affordable health care; Support S. 2016/ H.R. 4189, CONNECT for Health Act of 2023, a bill to support to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; A letter to the Department of Veterans Affairs (VA) expressing significant concerns about Cotivitis audit and appeals process, including its inadequate appeals procedures, the scope of audits being performed and the untenable timelines that are being executed; Support S. 3211/ H.R. 6205, Healthcare Workforce Resilience Act, a bill to support Healthcare Workforce Resilience Act to enhance our Nations nurse and physician workforce by recapturing unused immigrant visas; Support for Reauthorization of PAPHA, The Pandemic and All-Hazards Preparedness Act (PAHPA), To amend the Public Health Service Act to reauthorize certain programs with respect to public health security and all-hazards preparedness and response related to the Administration for Strategic Preparedness and Response and certain programs with respect to public health security and all-hazards preparedness and response related to the Centers for Disease Control and Prevention, and for other purposes; Support H.R. 6430, Rural Community Hospitals (ARCH) Act, a bill to support the Assistance for Rural Community Hospitals (ARCH) Act; To support small rural hospitals for which Medicare patients make up a significant percentage of inpatient days or discharges, Congress established the Medicare- dependent Hospital (MDH) program in 1987, allowing eligible hospitals to receive the sum of their prospective payment system (PPS) payment rate, plus three- quarters of the amount by which their cost per discharge exceeds the PPS rate; Support H.R. 4531/ S.3393, Patients and Communities Reauthorization Act, a bill to reauthorize certain programs that provide for opioid use disorder prevention, recovery, and treatment, and for other purposes; A letter to the FDA on its laboratory developed tests (LDTs) proposed rule urging the agency to not apply its device regulations to hospital and health system LDTs because they are not devices; rather, they are diagnostic tools developed and used in the context of patient care. Instead, we urged the FDA to continue to apply its enforcement discretion to hospital and health system LDTs; Submit Statement to the Committee on Energy and Commerce Subcommittee on Health hearing, Supporting Access to Long-Term Services and Supports: An Examination of the Impacts of Proposed Regulations on Workforce and Access to Care to share the hospital fields comments on proposed regulations for minimum staffing standards for LTC facilities and their potential impact on access to care.

Contacted: Food & Drug Administration (FDA); Environmental Protection Agency (EPA); SENATE; Health Resources & Services Administration (HRSA); HOUSE OF REPRESENTATIVES; Occupational Safety & Health Administration (OSHA); Labor, Dept of (DOL); Health & Human Services, Dept of (HHS); Office of Management & Budget (OMB); Centers For Medicare and Medicaid Services (CMS)

Bills named: S. 3393 (118th), H.R. 4189 (118th), H.R. 2534 (118th), S. 2768 (118th), H.R. 2411 (118th), H.R. 3440 (118th), H.R. 2691 (118th), S. 2364 (118th), H.R. 977 (118th), S. 2510 (118th), S. 2016 (118th), S. 470 (118th), H.R. 1110 (118th), H.R. 2584 (118th), H.R. 3046 (118th), H.R. 2559 (118th), H.R. 4713 (118th), S. 1636 (118th), H.R. 4531 (118th), H.R. 2389 (118th), H.R. 6205 (118th), S. 3211 (118th), S. 1110 (118th), H.R. 2412 (118th), H.R. 6430 (118th), S. 940 (118th)

Budget/Appropriations BUD

Continue to monitor the FY 2023 budget to prevent or minimize hospital cuts; Support a bill to reauthorize the program of payments to childrens hospitals that operate graduate medical education programs; Letter to House and Senate Labor/ HHS Appropriations Subcommittee Chairs and Ranking Members on appropriations priorities regarding funding for health care programs for fiscal year (FY) 2024. Americas hospitals are facing many challenges and we appreciate you considering the effect your decisions have on hospitals ability to provide care to their patients and communities. We ask you to give favorable consideration to funding for health care programs that have proven successful in improving access to quality health care for patients and communities across America.

Contacted: Office of Management & Budget (OMB); HOUSE OF REPRESENTATIVES; Labor, Dept of (DOL); Health & Human Services, Dept of (HHS); SENATE; White House Office