What to Expect in the Federal Healthcare Arena

As the nation awaits the outcome of the federal court case that ruled the Affordable Care Act unconstitutional, and as the public wonders when and if the federal government will ever get up and running full steam again, the American Hospital Association (AHA) last week laid out its 2019 public policy agenda.  Since the federal healthcare agenda is tied inextricably to the state’s, it’s worth taking note of what the AHA has in store.

Among many initiatives, AHA said it would:
“continue to actively defend the constitutionality of the ACA in the courts and promote its benefits in the halls of Congress and in the public arena.”
ensure patients have access to “a minimum set of essential health benefits and enforcing existing federal parity laws to ensure coverage for physical and behavioral health benefits, including substance use disorder treatment.”
“eliminate Medicaid Disproportionate Share Hospital cuts.”
“restore vital funding and prevent further cuts to the 340B drug savings program.”
“ensure patient access to the highest quality primary care and other outpatient services by rejecting additional payment cuts that don’t recognize legitimate differences among provider settings (also known as site-neutral payment policies).”
“pass the Standard Merger and Acquisition Reviews through Equal Roles (SMARTER) Act, which would help rebalance the merger review process to support the ability of hospitals to become more integrated, aligned, efficient and accessible to patients.”
“expand access to care through the use of telehealth and other technologies by providing Medicare coverage and reimbursement for such services and including telehealth waivers in all new care models.”
“continue to streamline and coordinate quality measures to focus on the ‘measures that matter’ most to improving health and outcomes while reducing burden on providers.”
“promote inclusion of sociodemographic factors affecting health in quality measurement programs to reduce health care disparities.”
“ensure patients’ access to accurate quality information by suspending and modifying the faulty hospital star ratings.”
“eliminate the Recovery Audit Contractor contingency fee structure and instead direct CMS to pay RACs a flat fee, as every other Medicare contractor is paid.”
“support state efforts to expand scope of practice laws, allowing non-physicians to practice at the top of their licenses.”
“support efforts to protect the hospital workforce from violence, especially in the emergency department, as well as policies to strengthen clinician resiliency.”

AHA’s full document is here.  In many instances, MHA and its members have worked with the state’s congressional delegation on the issues AHA has outlined, or the Massachusetts hospital community has sought legislative or regulatory solutions within the state to address the issues.