House of Representatives Subcommittee Holds Hearings on Medicare Payment Policies

On October 19, 2023, the U.S. House of Representatives, despite not have a Speaker of the House, held a meeting of the Energy and Commerce Health Subcommittee, chaired by Representative Frank Pallone (R) of New Jersey.

During the meeting, Dr. Meena Seshamani, MD, PhD, Director, CMS; Ms. Leslie Gordon, Director, Health Care, GAO; and Mr. Paul Masi, Executive Director, Medicare Payment Advisory Commission, served as witnesses and experts who testified on the following topics:

1. Aspects of the Work Geographic Index in the Physician Fee Schedule
2. Payments for clinical laboratory tests
3. Incentive payments for participation in Accountable Care Organizations
4. Changes to Prior Authorization Requirements under Medicare
5. Creation of a shared savings pilot program for use of biosimilars
6. Increase Medicare maximum relative value unit (RVU) adjustments from $20 million to $53 million in 2025 and then increases in concert with the Medicare Economic Index every 5 years thereafter
7. Clarification of the In-Office Ancillary Services Exception to Stark Law for Drugs
8. Codifying In-Home Cardiopulmonary Rehab Flexibilities from COVID-19 response
9. Exempting certain MA providers from Merit-Based Incentive Payment System (MIPS) adjustments
10. Clarifying manufacturer transparency reporting requirements for certain transfers
11. Increasing nonfacility practice expense RVUs in the Physician Fee Schedule
12. Changes to quality payment metrics
13. Exemptions from Stark Law for covered rural hospitals
14. Telehealth privacy
15. Increasing access to home infusions
16. Payment changes to durable medical equipment, prosthetics/orthotics, and supplies
17. Use of real time benefit information in PDPs
18. Changes to outpatient therapy requirements to sync with applicable state laws

Many of these topics are high priorities for ISASS and would be important improvements for physician payment and practice policy although it is unclear whether the current House can pass anything that will pass the Senate and be signed into law by the president.

To read the meeting announcement, see here.