The House on Tuesday is expected to approve a hospital-backed bill that will alter Medicare readmissions data at safety-net hospitals and exempt hospital outpatient buildings already under construction and certified cancer hospitals from new, lower rates.
The bill also includes a slight reduction to the increase in Medicare payments that was passed in the Medicare Access and CHIP Reauthorization Act. That increase, set to go into effect in October 2017, still did not offset the 1.5% cut going into effect this October.
The bipartisan bill, dubbed the Helping Hospital Improve Patient Care Act, was introduced last month by the leadership of the House Ways and Means Subcommittee on Health. It passed the full committee unanimously.
It is supported by the American Hospital Association, the Federation of American Hospitals and the Association of American Medical Colleges.
Hospitals pushed hard to exempt off-campus hospital outpatient buildings from the lower rates included in last year's budget agreement. The bill being considered Tuesday would extend that exemption to hospitals with facilities currently under construction, since the decision to build was based on higher rates.
The readmissions adjustment for safety-net hospitals was welcomed by pro-provider lobbyists. Blair Childs, senior vice president for public affairs at Premier, said in a blog post that research shows how socioeconomic factors can directly affect the readmission rates of the patient population.
Research from America's Essential Hospitals found that under the Affordable Care Act's Hospital Readmissions Reduction Program, hospitals serving a large volume of low-income patients are more likely to be penalized for high readmissions.
“Penalizing hospitals treating the most vulnerable populations for outcomes beyond their control must be addressed,” Childs wrote.
However, other lobbyists said the bill doesn't go far enough in protecting hospital outpatient buildings. Larry Vernaglia, chair of the Health Care Industry Team at the Foley and Lardner Law Firm, said there is confusion about what rates existing outpatient buildings would use after an expansion or relocation.
Also, buildings are not considered under development unless a construction contract is signed. Some hospitals have made considerable investments in an expansion without having signed a contract. They stand to lose out under the new bill, Vernaglia said.
The industry had little time to weigh in on the budget agreement last year. The new bill is also moving "too fast," he said.
The bill also includes a five-year extension to the Rural Community Hospital Demonstration Program, which is testing cost-based reimbursement at small rural hospitals that do not meet the requirements for a critical access hospital.
“This program has become vital to participating hospitals and is providing valuable data on potential new models for these vulnerable hospitals,” AHA Executive Vice President Tom Nickels said in a letter to lawmakers.
