Public Health Priorities, Drug Price Transparency and Surprise Medical Billing Legislation Advance through U.S. House Committee > Hospital Association of Pennsylvania

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Public Health Priorities, Drug Price Transparency and Surprise Medical Billing Legislation Advance through U.S. House Committee

July 19, 2019

This week, the U.S. House Energy & Commerce Committee vetted and approved a panel of bills aimed at promoting public health priorities, protecting patients from surprise medical bills, and providing transparency with respect to prescription drug prices. Importantly, the committee took action to avert impending cuts to Medicaid payments that, if applied, will pose significant financial challenges for Pennsylvania hospitals.

In an effort to promote the health care workforce and strengthen our nation’s health care system, the committee took targeted action to support workforce development by passing the following bills:

  • H.R. 2781, the Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019, which would reauthorize Title VII health care workforce development grant programs that support loan repayment and provider training experiences in primary care, dentistry, rural and underserved areas, and in community-based settings. The bill also updates the Geriatric Workforce Enhancement program and reauthorizes the Investment in Tomorrow’s Pediatric Health Care Workforce program, which provides loan repayment for certain qualifying pediatric specialists and subspecialists
  • H.R. 728, the Title VIII Nursing Workforce Reauthorization Act, which would reauthorize nursing workforce development programs that support traineeships, loan repayment, and scholarships for nurses to attain advance practice status and become nursing faculty
  • H.R. 2328, the Reauthorizing and Extending America’s Community Health (REACH) Act, which would reauthorize and extend funding for community health centers and make investments in the health care workforce by supporting the National Health Service Corps (NHSC) and the Teaching Health Center Graduate Medical Education Program

Of direct significance to the hospital community, H.R. 2328 incorporated policy to address surprise balance billing and provide relief from Medicaid disproportionate share hospital (DSH) cuts.

Policy included in H.R. 2328—H.R. 3630, the No Surprises Act—would prohibit the practice of billing a patient for the difference between what a health insurance chooses to reimburse and what the health care provider has charged for the services and care. This most frequently happens when a patient is receiving out-of-network emergency services and certain out-of-network ancillary and post-stabilization services.

The hospital community has advocated to protect patients from surprise medical bills by prohibiting balance billing and holding patients harmless to in-network cost sharing obligations, but urged Congress to embrace the notion that once patients are protected, providers and insurers should resolve any payment disputes without government interference.

HAP and Pennsylvania hospitals look forward to continue working with Pennsylvania federal elected officials to craft a solution to surprise medical bills that takes the patients out of the center of payment disputes between insurance companies and health care providers, and does so without imposing rate setting that could have the effect of disrupting local market dynamics and incentivizing insurers to avoid contracting with providers.

HAP applauds the committee for passing legislation that would address impending Medicaid DSH cuts by eliminating the payment reductions for fiscal year (FY) 2020 and FY 2021 and reduce the cuts by half for FY 2022.

HAP has strongly advocated for Congress to act to delay the DSH cuts, imparting the message that safety net hospitals that rely on Medicaid DSH dollars to help offset the cost of uncompensated care will be significantly impacted by a cut of this magnitude.

Two pieces of legislation that earned approval by the Committee have been championed by Pennsylvania lawmakers:

  • Congressman Mike Doyle (D, PA-18) is the lead sponsor of H.R. 1058, the Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act of 2019, which would reauthorize funding for programs targeted at addressing issues surrounding autism at the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), and HRSA through FY 2024
  • Senator Bob Casey (D, PA) is the lead proponent of the Senate companion to H.R. 776, the Emergency Medical Services for Children Program Reauthorization Act of 2019, which would reauthorize the Emergency Medical Services for Children Program at $22.3 million dollars each year through FY 2024

In an effort to promote greater transparency for consumers relative to the price of prescription drugs, the committee approved H.R. 2296, the More Efficient Tools to Realize Information for Consumers (METRIC) Act, which would require certain drug manufacturers to submit documentation to the Secretary of the Department of Health and Human Services (HHS) before increasing the price of a qualifying drug.

The committee also passed:

  • H.R. 2507, the Newborn Screening Saves Lives Reauthorization Act of 2019, which would reauthorize newborn screening programs for five years with appropriations of $60.65 million per year through FY 2024
  • H.R. 2035, the Lifespan Respite Care Reauthorization Act of 2019, which would reauthorize the Lifespan Respite Care program at $20 million in FY 2020, and increase the funding level by ten million dollars each year thereafter through FY 2024

Please contact Jeff Becthel, HAP’s senior vice president of health economics and policy, or Laura Stevens Kent, HAP's vice president, federal advocacy with questions.

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