POLICY BRIEFINGS

Finance Committee Questions POD Reporting


Bipartisan leadership of the Senate Finance Committee have sent a letter to the U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) and the Centers for Medicare and Medicaid Services (CMS) outlining concerns about physicians who fail to disclose when they have a financial stake in the medical devices that are supplied to their practices. A physician-owned distributorship (POD) is an arrangement in which a physician purchases ownership shares in an entity that sells medical devices used in the physician’s surgeries. Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) ask the agencies how they are coordinating to ensure that POD reporting is taking place and that the data reported is accurate. They also ask about what changes can be made to the Sunshine Act or the Stark Law to improve the accuracy of reporting, and whether OIG’s hospital guidance has been updated to account for such distributorships. The lawmakers request a response no later than April 15.


Azar Calls for Stark Law Update


HHS Secretary Alex Azar has suggested that laws which prohibit providers from having a financial stake in the entities to which they refer patients are hindering the advancement of value-based care. Azar recognized the importance of preventing health care fraud, while expressing support for updating the 30-year-old anti-kickback statute known as the Stark Law during a speech before a conference of health lawyers last week. The administration sought input on a proposal to update the anti-kickback statute in June 2018, and CMS Administrator Seema Verma has stated that a regulation to reform the Stark Law will be issued later this year.


Energy and Commerce Expands Investigation into Short-Term Health Plans


The House Energy and Commerce Committee has sent two additional letters to Pivot Health and LifeShield National Insurance Co. as a part of its probe into the sale of short-term, limited-duration health insurance plans. Democratic lawmakers characterize such plans as “junk” insurance because they do not have to comply with all of the ACA’s consumer protections and they have expressed concerns that consumers are being misled about the benefits covered by such plans. The panel requests information from Pivot Health and LifeShield about their policies and marketing practices for shortterm, limited-duration health insurance products.


WH Releases Full FY 2020 Budget Details


One week after releasing the main volume of the President’s budget request for fiscal year (FY) 2020, the White House issued its full budget appendix with program level information.



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