House to vote on 'clean' debt limit bill   02/11/2014
The House of Representatives is expected to vote tonight on a “clean” bill to extend the nation’s borrowing authority for approximately one year without offsetting the cost of the extension or making other policy changes. The Treasury Department expects that the nation will exhaust its ability to borrow money to meet its financial obligations by Feb. 27 without congressional action. House Republican leaders yesterday circulated a proposal that would have included in the debt limit legislation a provision restoring a cut to veterans’ benefits by extending the sequestration for mandatory spending – including Medicare – until 2024. While the debt limit bill to be voted on tonight will not contain the sequestration cuts, the House this afternoon voted 326 to 90 to approve a second bill to restore the veterans’ benefits using the sequestration extension as the offset. The AHA, along with eight other organizations representing the nation’s hospitals, yesterday opposed using Medicare funds for non-health care related purposes, noting, “Medicare is meant to assure seniors access to needed medical care, not serve as a piggybank for other programs. It is bad policy to further extend Medicare sequester cuts that could undermine care for seniors.”
Senate passes bill to extend direct supervision enforcement moratorium   02/11/2014
The U.S. Senate last night approved by unanimous consent legislation (S. 1954) that would extend through 2014 the enforcement moratorium on the outpatient therapy “direct supervision” policy for critical access hospitals and rural prospective payment system hospitals with100 or fewer beds. AHA has urged CMS to extend the moratorium, which expired Jan. 1, to protect access to outpatient therapeutic services. If approved by the House, S. 1954 would give Congress more time to enact legislation such as the AHA-supported Protecting Access to Rural Therapy Services Act (H.R. 2801/S. 1143), which would adopt a default standard of “general supervision” for outpatient therapeutic services, among other provisions.
Rural hospital leaders seek support for key issues from Capitol Hill   02/11/2014
“Decisions made by policymakers and legislators in Washington are having a profound effect on rural hospitals,” AHA President and CEO Rich Umbdenstock told more than 500 rural hospital leaders today at a special briefing at the 2014 Rural Health Care Leadership Conference in Phoenix, urging them to make their concerns known. “If your legislators don’t hear from you, they will assume that you are OK with those decisions… We need to stave off possible cuts and send Washington a strong message:  protect rural health care!” Attendees were briefed by AHA Vice President of Legislative Affairs Lisa Kidder Hrobsky and Senior Associate Director of Policy Priya Bathija on the latest rural health care developments from Washington, including the status of legislation to repeal and replace the sustainable growth rate formula for physician payment updates, extend various Medicare provisions for rural hospitals, remove the 96-hour rule for critical access hospitals, and provide relief from the direct supervision policy for CAHs and rural prospective payment system hospitals with 100 or fewer beds. The rural hospital leaders also took part in a special AHA Virtual Advocacy Day, engaging their lawmakers through emails, phone calls and social media. Those unable to attend the conference participated via webcast and through an online advocacy action center.
IRS finalizes ACA employer responsibility regulations   02/11/2014
The Internal Revenue Service yesterday issued final regulations implementing employer responsibility provisions under the Patient Protection and Affordable Care Act. Among other changes, the rule gives employers with 50-99 full-time workers an extra year – until 2016 – to avoid a shared responsibility payment if they fail to offer adequate health coverage. It also eases requirements for employers with 100 or more full-time employees by allowing them to avoid the penalty if they offer adequate coverage to 70% of full-time employees in 2015 and 95% by 2016, according an agency factsheet. Among other changes, the final rule clarifies what employees are considered full-time, generally excluding volunteer firefighters and emergency responders, seasonal workers, and students in federal or state-sponsored work-study programs. It also provides an optional look-back method to determine whether employees with varying hours are full-time.
CMS seeks input on outpatient specialty care payment models   02/11/2014
The Centers for Medicare & Medicaid Services is accepting stakeholder comments through March 13 on two potential episode-based payment models for specialty practitioner services in the outpatient setting. For more information or to comment on the models, visit
Senate Finance leaders issue summary of mental health recommendations   02/11/2014
Leaders of the Senate Finance Committee last week issued a summary of recommendations received in response to their August request to stakeholders for ways to improve the nation’s behavioral health care system. “The recommendations that were received by the Senate Finance Committee are an important resource for the Committee to use to improve the quality of mental and behavioral health services provided through Medicare and Medicaid,” the document concludes. “These programs were designed to serve some of our country’s most vulnerable citizens, and should be enhanced to provide better quality of care.” AHA submitted recommendations in September.
FDA working to ease IV solution shortages   02/11/2014
The Food and Drug Administration is working with manufacturers to ease a shortage of intravenous solutions, particularly 0.9% sodium chloride injection bags, according to a recent statement by the agency. The bags are used to provide patients with necessary fluids for hydration and other conditions. “The shortage has been triggered by a range of factors including a reported increased demand by hospitals, potentially related to the flu season,” the agency said. “We are working with the three manufacturers…to help preserve the supply of these necessary products.” For updates on specific shortages, see the FDA and American Society of Health-System Pharmacists’ drug shortage lists. For help in managing emergency shortfalls, the Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response recommends its website on crisis standards of care and a 2012 report by the Association of State and Territorial Health Officials on mitigating the effects of medication shortages.