VA Legislation Passes, Congress Continues Work on Opioids and Disaster Response

On Wednesday, May 9, 2018, the House Committee on Veterans’ Affairs passed 16 bills out of committee, including the VA MISSION Act and the Blue Water Navy Vietnam Veterans Act. H.R. 5674, the Department of Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks, or VA MISSION Act, includes three pieces of legislation that have been considered by either the House or Senate Committees on Veterans’ Affairs. The bill includes strong prompt payment language that will help ensure orthopaedic surgeons are able to take care of veterans in their communities. Additionally, the bill would streamline the department’s duplicative community care programs into one cohesive program; create a non-partisan process for reviewing VA’s assets to ensure veterans can access the care they have earned and expand the Department of Veterans Affairs’ Post-9/11 Caregiver Program to all eras. It also allows for medical record sharing with community providers and makes it easier for VA providers to participate in PDMPs.

The House Energy and Commerce Committee last week marked up over 20 bills as part of the panel’s work to address the opioid epidemic The measures passed with bipartisan support and touched on a number of different priorities for combating opioid abuse. For example, one bill requires MedPAC to report on opioid payment, adverse incentives, and data under the Medicare program. Another includes requiring the Secretary of Health and Human Services (HHS) to develop guidance on pain management and prevention of opioid use disorder for hospitals receiving payment under Part A, while a different proposal provides for a technical expert panel to provide recommendation on reducing opioid use in the surgical setting. Lawmakers also proposed requiring Medicare Advantage (MA) plans under Part C and Part D drug plans to provide info relating to the safe disposal of Rx drugs that are controlled substances.

Last month, Senators Burr, Casey, Alexander, and Murray released a bipartisan discussion draft to reauthorize the Pandemic and All-Hazards Preparedness Act, making targeted improvements to the tools at our nation’s disposal to prepare for and respond to the threats that we face, whether naturally occurring like pandemic flu, or as a result of a deliberate attack on our country. The reauthorization legislation, titled the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPAI), focuses on improvements to programs within the original framework to address these 21st century threats. According to the legislators, Ebola, Zika, and a destructive hurricane season have all made clear that these threats are constantly evolving, requiring further work to protect our communities.

On April 24, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that makes updates to Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS). According to CMS, these changes and other policy proposals will “empower patients through better access to hospital price information, improve the use of electronic health records, and make it easier for providers to spend time with their patients.”

On May 7, 2018, Centers for Medicare and Medicaid Services’ (CMS) Administrator Seema Verma delivered a speech that touched on the Department of Health and Human Services’ (HHS) efforts to move to a “value-based” health care payment system, including information on pending Center for Medicare and Medicaid Innovation (CMMI) initiatives and efforts to address drug pricing in Medicare Part B and Medicare Part D. Verma also discussed efforts to reduce regulatory burdens facing providers, including efforts to streamline measures and reduce reporting burdens.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, and the Centers for Medicare & Medicaid Services (CMS) then replaced it with the Quality Payment Program. Remember – the Quality Payment Program has two tracks you can choose: Advanced Alternative Payment Models (APMs) OR the Merit-based Incentive Payment System (MIPS). AAOS has more information on our website, here: www.aaos.org/MACRA-DeliveryReform/.

Congress Leery of Trump’s Cuts to Children’s Health Program, The Wall Street Journal, 5/8/18

House Panel Oks Plan to Grow VA Private Care, Associated Press, 5/8/18

CMS Unveils New Rural Health Strategy, Modern Healthcare, 5/8/18

Blankenship Loses West Virginia Primary; Cordray Defeats Kucinich in Ohio, The New York Times, 5/8/18

Drug Distributors to Face Lawmakers, Politico, 5/8/18

CMS Medicare ID Cards Hit Another Potential Snag, Modern Healthcare, 5/7/18

Trump Calls on Congress to Pull Back $15 Billion in Pending, Including CHIP, The Washington Post, 5/7/18

House Committee Plans to Move More Than 50 Opioid Bills By May 17, The Washington Examiner, 5/4/18

New Front on Opioid Litigation: Suits Over Rising Premiums, The Wall Street Journal, 5/2/18

Medicaid Won’t Look the Same Next Year, Roll Call, 4/25/18

Click here, to view the interactive version of the map below, which features each state’s PAC support for 2017.

To learn more about the Advisor’s Circle, email Stacie Monroe at monroe@aaos.org.