POLICY BRIEFINGS


CBO: Ruiz/Roe Surprise Billing Approach Would Increase Deficit


A new analysis from the Congressional Budget Office (CBO) indicates that the legislation introduced by Reps. Raul Ruiz (D-Calif.) and Phil Roe (R-Tenn.) to address surprise insurance gaps would increase the federal deficit by $15 billion over the next decade. The budget agency’s score of the bill was obtained by The Hill after being emailed to a congressional office. The CBO’s official score of the competing surprise billing legislation advanced by the House Energy and Commerce Committee shows savings of more than $20 billion over 10 years. Unlike the approach proposed by Reps. Ruiz and Roe, the Energy and Commerce bill would initially set a benchmark payment rate that insurers would pay providers for out-of-network care based on the median negotiated rate in a given area. The Ruiz/Roe legislation instead provides for an independent dispute resolution (IDR) process under which an arbiter would take into account the amount that physicians charge before payer negotiations take place. The CBO cites the increased payments to physicians that have been observed in New York since the state passed a similar policy in its score of the Ruiz/Roe bill. Lawmakers in both chambers continue to pursue an agreement on surprise billing.


Senate Passes Ebola Eradication Act


The Senate passed legislation last week directing the United States Agency for International Development (USAID) to act in response to the threat posed by Ebola in the Democratic Republic of the Congo (DRC), South Sudan, and Burundi. S. 1340 also directs the USAID to report to Congress on its efforts in the eastern part of the DRC and on proposed additional legal authorities needed to improve such efforts. The bill was agreed to by unanimous consent.


Warner Files Discharge Petition To Reverse WH Waiver Regulation


Sen. Mark Warner (D-Va.) has filed a discharge petition to force a Senate vote on a Congressional Review Act resolution to reverse recent regulations from the Trump administration that make it easier for health insurance plans to qualify for waivers from the Affordable Care Act’s (ACA) consumer protections. The petition, which is supported by the entire Senate Democratic caucus, must be voted on no later than November 12. It requires a simple majority to pass, meaning that Democrats must gain the support of four GOP colleagues in order for the resolution to be successful.


Krishnamoorthi Calls on Companies to End E-Cigarette Advertising


House Oversight and Reform Subcommittee on Economic and Consumer Policy Chairman Raja Krishnamoorthi (D-Ill.) is calling on e-cigarette manufacturers to stop all television, radio, print, and digital advertising in the U.S. His request follows the announcement from market-leader Juul that it would immediately stop advertising its products in light of significant increases in vaping among youths.


Grassley to Continue Seeking Details on Puerto Rico’s Medicaid Program


Senate Finance Committee Chairman Chuck Grassley (R-Iowa) stated that he received more questions than answers from Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma in response to a letter lawmakers sent the agency in July regarding how much Puerto Rico receives in Medicaid funding. The letter also posed questions regarding whether there were processes in place to reduce waste, fraud, and abuse of federal Medicaid dollars and when Puerto Rico planned to implement processes to increase transparency. According to Grassley, Verma’s response is inconsistent with the information he has gathered from the local government of Puerto Rico. He intends to follow up with the agency on these issues.


Lawmakers Urge CMS to Reconsider Cuts to EEG/VEEG Services


A group of more than 60 bipartisan lawmakers have written to CMS urging the agency to reconsider its proposed payment reductions for long-term EEG (electroencephalograph) and video EEG (VEEG) professional and technical service codes. Such testing services are used in the diagnosis and treatment of uncontrolled or intractable epilepsy. The lawmakers raise concerns that the payment reductions could impede patient access to long-term EEG and VEEG services, which could increase patient risk of subsequent seizures, brain damage, disability and death, worsen surgical outcomes, and result in higher health care costs overall. The letter was led by Reps. Earl Blumenauer (D-Ore.), Brad Wenstrup (R-Ohio), Terri Sewell (D-Ala.), and Cathy McMorris Rodgers (R-Wash.).


Upcoming Congressional Hearings and Markups


House Energy and Commerce Subcommittee on Health field hearing on the public health threat posed by gun violence; time TBD, University of Chicago Medical Center; October 3



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