AMERICAN HOSPITAL ASSOCIATION for AMERICAN HOSPITAL ASSOCIATION

Health Issues HCR

Support The Importance of Rural Health Access for American Communities and the need for rural hospitals and their value to rural areas; Support of HR 1326 Health Care Price Transparency Promotion Act of 2013, to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; Support CMS proposed rule aimed at reducing burden and promoting efficiency for hospitals,critical access hospitals and other providers. The rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation; Support S 689 Mental Health Awareness and Improvement Act of 2013, a bill to reauthorize and improve programs related to mental health and substance use disorders; Support S 961 Health Care Safety Net Enhancement Act of 2013, a bill to improve access to emergency medical services; Oppose HR 2027 Expanding Patients' Access to Quality Care Act of 2013, a bill to amend section 1877 of the Social Security Act to modify the requirements for hospitals to qualify for the rural provider and hospital exception to physician ownership or investment prohibition in order to take into account hospitals that were under construction or development at the time of imposing such requirements, hospital expansions, and hospitals in financial distress; Support 340B Drug Program; Support Rep. Lynn Jenkins(R-KS) H. Res 356 in support of rural hospitals and rural health care providers. The resolution calls access to rural hospitals and other health care providers essential to the survival and success of communities; Support for the current October 1, 2014 implementation date for adoption of the International Classification of Diseases, Tenth Revision, Clinical Modifications (ICD-10-CM) for all health care providers, as well as the adoption of the Procedure Coding System of ICD-10 for hospital reporting of inpatient procedures; Encourage HHS to speed up processing of CAC applications and discussed questions about the new Marketplaces; Participated in the White House National Mental Health Conference and had several discussions on how hospitals can help raise awareness about mental health in their communities with ACA; Discussions with the Senate Finance Committee in response to the Committees outreach to behavioral health stakeholders seeking input to help improve the behavioral health care system; Helping to shape agencys forthcoming compliance initiative related to hospitals reporting obligations to the National Practitioner Data Bank; Support S. 2196 Good Samaritan Health Professional Act, by extending to licensed, volunteer health professionals the same protective standards included in the Volunteer Protection Act of 1997, this legislation takes critical steps to help victims have access to critical onsite medical attention during declared federal disasters; Support S 2501 Hospital Readmissions Program Accuracy and Accountability Act of 2014, to amend title XVIII (Medicare) of the Social Security Act, with respect to the Hospital Readmissions Reduction Program, to direct the Secretary of Health and Human Services (HHS), in determining a hospital's excess readmission ratio for purposes of making payments for discharges starting in FY2016, to risk adjust readmissions to account for patient socioeconomic status; Requested that the Secretary issue a written statement on behalf of the entire department confirming that the HHS is not discouraging hospital-affiliated or other charitable foundations from subsidizing premiums purchased through the new Health Insurance Marketplaces (exchanges) or cost-sharing expenses for needy enrollees; Support HR 4067, to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014; HR 4810 Veteran Access to Care Act of 2014 and H.R.3230 Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014, support specific provisions in the two bills and to address this issue and allow veterans to more easily secure care from civilian providers. We urge Congress to move expeditiously to resolve differences between the House and Senate bills and look forward to working with our VA colleagues, Congress and the Administration to ensure veterans receive the care they need when they need it.

Contacted: Internal Revenue Service (IRS); Health & Human Services, Dept of (HHS); Health Resources & Services Administration (HRSA); Federal Trade Commission (FTC); SENATE; HOUSE OF REPRESENTATIVES; Centers For Medicare and Medicaid Services (CMS)

Bills named: H.R. 3230 (113th), H.R. 1326 (113th), H.R. 2027 (113th), H.R. 4067 (113th), S. 2196 (113th), H.Res. 356 (113th), H.R. 4810 (113th)

Medicare/Medicaid MMM

Submitted comments on the Hatch Entitlement Reform in support of the several key reforms proposed for the Medicare program as alternative reductions to provider payments; Support S 351 Protecting Seniors Access to Medicare Act, a bill to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; Support HR 297 and S1557, Children's Hospital GME Support Reauthorization Act of 2013, the bill would reauthorize the CHGME program for an additional five years through fiscal year (FY) 2017; Support HR 1250 and S 1012 Medicare Audit Improvement Act of 2013, a bill to amend title XVIII of the Social Security Act to improve operations of recovery auditors under the Medicare integrity program, to increase transparency and accuracy in audits conducted by contractors; Support S. 596 Fostering Independence Through Technology Act of 2014, a bill to establish pilot projects under the Medicare program to provide incentives for home health agencies to furnish remote patient monitoring services that reduce expenditures under such program; Support HR 1787 and S 842 Rural Hospital Access Act of 2013, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support HR 1920 and S 1555 DSH Reduction Relief Act of 2013, a bill to amend titles XVIII and XIX of the Social Security Act to provide for a delay in the implementation schedule of the reductions in disproportionate share hospital payments;AHA submitted a statement to the Presidents and Other Bipartisan Proposals to Reform Medicare Post-Acute Care Payments hearing to provide input on proposals to reform Medicares post-acute care payment systems; AHA submitted a statement to the Program Integrity: Oversight of Recovery Audit Contractors hearing supporting increased oversight of Recovery Audit Contractors (RACs); Support HR 2578 Rural Hospital Fairness Act of 2013, a bill to amend title XVIII of the Social Security Act to extend for one year the hold harmless provision for small rural hospitals and sole community hospitals under the Medicare prospective payment system for hospital outpatient department services related to enhanced physician supervision requirements; AHA submitted a statement to the Health Care Quality: The Path Forward hearing in support of improving transparency for the public, continuing and enhancing support of efforts to improve the safety and quality of the care delivered,and reduce unnecessary hospital expenditures; Support HR 2931 Fairness in Health Care Claims, Guidance and Investigations Act, a bill to amend the false claims provisions of title 31, United States Code, with respect to health care programs; Request additional guidance on and delay of two-midnight rule from CMS; Request issue corrected data on OPPS proposed rule and delay comment period from CMS; Discussion of ACAs patient safety evaluation system with CMS; Discussed the improvements to the National Practitioner Data Bank and new compliance efforts at HRSA; Discussions of Medicaid presumptive eligibility; Medicaid DSH; and request release of DSH audit rule with CMS; Follow up on GPO exclusion related to 340(b) entities; discussions to help shape upcoming proposed rule on 340B with HRSA; Discussed the Qualified Health Plans (QHP) 90day grace period with HHS and its implications for hospitals; Support HJ Res 59, a continuing Appropriations Resolution for 2014, which includes a provision that averts Medicare physician payment cuts as Congress continues to work on a replacement of the flawed SGR formula; Support HR 3444 Critical Access Hospital Flexibility Act of 2013, to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; Support H.R.3698 and S. 2037 Two-Midnight Rule Delay Act of 2013, to delay the enforcement of the Medicare two-midnight rule for short inpatient hospital stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays; Requested CMS and ONC to extend the EHR Incentive program regulatory timelines for 2014 and allow all providers greater flexibility in Stage 2 by giving all hospitals the option to make the transition to the 2014 Edition Certified EHR and the Stage 2 requirements (or the revised Stage 1 requirements, as applicable) over the course of 2014 or 2015; Support HR 3991 and S 2037 Critical Access Hospital Relief Act of 2014, amends title XVIII (Medicare) of the Social Security Act to repeal the 96-hour physician certification requirement for inpatient critical access hospital services under which a physician must certify that a patient may reasonably be expected to be discharged or transferred to a hospital within 96 hours after admission to the critical access hospital; Support HR 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act, to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support H.R. 2801 and S 1143 Protecting Access to Rural Therapy Services (PARTS) Act of 2013, a bill to adopt a default standard of general supervision for outpatient therapeutic services, develop a reasonable exceptions process with provider input to identify specific procedures that require direct supervision, ensure that, for CAHs, the definition of direct supervision is consistent with the CAH conditions of participation that allow a physician or NPP to present within 30 minutes of being called and prohibit enforcement of CMSs retroactive reinterpretation that the direct supervision requirements applied to services furnished since January 1, 2001; S.1932/H.R. 3890 Better Care, Lower Cost Act , AHA has not taken position on the bill, but did establish an AHA working group to analyze the legislation to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program to provide integrated care for Medicare beneficiaries with chronic conditions; requested that the increasing number of hospital compliance reviews performed by the Office of Inspector General (OIG) Office of Audit Services in which the OIG has extrapolated audit findings to estimate Medicare overpayments to the hospitals and the hospitals Medicare Administrative Contractors (MACs)have sought to recover the extrapolated overpayment amounts be halted without delay; Support HR 5481, The Flexibility in Health IT Reporting (Flex-It) Act, a bill to continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs.

Contacted: Federal Trade Commission (FTC); Internal Revenue Service (IRS); SENATE; HOUSE OF REPRESENTATIVES; Health Resources & Services Administration (HRSA); Health & Human Services, Dept of (HHS); Centers For Medicare and Medicaid Services (CMS)

Bills named: H.R. 3444 (113th), H.R. 2578 (113th), H.R. 297 (113th), H.R. 4188 (113th), S. 2037 (113th), H.R. 1250 (113th), H.R. 2801 (113th), H.R. 2931 (113th), S. 596 (113th), H.R. 3698 (113th), H.R. 3890 (113th), S. 1932 (113th), H.R. 1920 (113th), H.R. 5481 (113th), H.J.Res. 59 (113th), H.R. 3991 (113th), H.R. 1787 (113th)

Taxation/Internal Revenue Code TAX

Supporting the importance and continuation of the tax codes charitable contribution provisions for Americas nonprofit hospitals; requested changes to the Schedule H form and instructions to permit counting of hospital research expenditures as part of community benefit for exempt status.

Contacted: Internal Revenue Service (IRS); Centers For Medicare and Medicaid Services (CMS); HOUSE OF REPRESENTATIVES; Health Resources & Services Administration (HRSA); SENATE; Federal Trade Commission (FTC); Health & Human Services, Dept of (HHS)

Budget/Appropriations BUD

Opposing cuts to hospital payments in the Senate and House FY 2014 budget resolutions as savings to pay for replacement of sequester reductions. Monitoring develpoments related to HR 933 The Consolidated and Further Continuing Appropriations Act of 2013, a bill making appropriations for the Department of Defense, the Department of Veterans Affairs, and other departments and agencies for the fiscal year ending September 30, 2013.

Contacted: Internal Revenue Service (IRS); Centers For Medicare and Medicaid Services (CMS); HOUSE OF REPRESENTATIVES; Health & Human Services, Dept of (HHS); Federal Trade Commission (FTC); SENATE; Health Resources & Services Administration (HRSA)

Bills named: H.R. 933 (113th)

Labor Issues/Antitrust/Workplace LBR

Support HR 803 Supporting Knowledge and Investing in Lifelong Skills (SKILLS) Act, a bill to reform and strengthen the workforce investment system of the Nation to put Americans back to work and make the United States more competitive in the 21st century. Support HR 3633 Protecting Health Care Providers from Increased Administrative Burdens Act, clarifies Office of Federal Contract Compliance Programs (OFCCP) within the Department of Labor jurisdiction over hospitals participating in TRICARE ;Support HR 1406 Working Families Flexibility Act of 2013, a bill to amend the Fair Labor Standards Act of 1938 to provide compensatory time for employees in the private sector; Support HR 2346 Secret Ballot Protection Act, a bill to amend the National Labor Relations Act to ensure the right of employees to a secret ballot election conducted by the National Labor Relations Board; Urging IRS for purposes of section 4980H of the code to treat "on-call" hours consistent with the treatment of "on-call" under the Federal Fair Labor Statndards Act; discussion with FTC Commission about the importance of clinical integration in the changing health care delivery environment and how that the FTCs current merger/acquisition model is not compatible with the clinical integration delivery model.

Contacted: SENATE; Internal Revenue Service (IRS); Centers For Medicare and Medicaid Services (CMS); Health Resources & Services Administration (HRSA); HOUSE OF REPRESENTATIVES; Federal Trade Commission (FTC); Health & Human Services, Dept of (HHS)

Bills named: H.R. 2346 (113th), H.R. 3633 (113th), H.R. 1406 (113th), H.R. 803 (113th)

Law Enforcement/Crime/Criminal Justice LAW

Supporting framework for revising Stark/anti-kickback to permitting gainsharing arrangements; Monitoring the hospitals concerns about the impact of FTCs strategy related to retrospective review of hospital mergers; Discussed how HIPAA protects privacy and security of health information within hospital and other covered entities and their business associates and whether FTC has a role in protecting health information that is not otherwise protected by HIPAA.

Contacted: Health & Human Services, Dept of (HHS); Federal Trade Commission (FTC); Centers For Medicare and Medicaid Services (CMS); Internal Revenue Service (IRS); SENATE; Health Resources & Services Administration (HRSA); HOUSE OF REPRESENTATIVES