It’s hard to believe that fall is around the corner and that summer has come to an end. The schools are open, buses are on the road early in the morning, and the sun is setting earlier each day. But that doesn’t mean that your legislative committee is asleep at the wheel!
On the Federal level, the Senate HELP committee marked up the surprise billing legislation prior to their summer recess. It has most of what NAHU is looking for, especially no arbitration. There are network benchmarks to help determine ‘fairness’ or pricing. In the House Energy and Commerce Committee, there is legislation being discussed that has benchmarking but that bill has arbitration.
So that you are aware, benchmarking is:
1) Set by a percentage of Medicare (for example, at 125%)
2) It allows for a higher percentage based on area (and will pay rural providers more)
3) Arbitration would be baseball style. This means both sides would put forth their numbers and a “judge” will decide what is best. The issue here is that this requires attorneys and an independent arbiter. This arbiter could push rates higher especially for the self-insured.
4) Arbitration could take up to 6-months to complete and between the financial delay, the cost of an attorney for arbitration, and the ultimate decision, NAHU believes this provision to be outside of the best interest of all parties.
We are also waiting for the Cadillac Tax to be fully repealed. The House passed H.R. 748 by a large margin while the companion bill in the Senate (S. 684), with 62 co-sponsors, still languishes. NAHU is optimistic this will pass, and we are actively lobbying to passage of this legislation. We were told it is possible that if this bill does not pass on its own, it could be bundled with other legislation at year’s end.
Prescription Drug bills exist in both chambers but not only is there inter-chamber issues, there are competing items within both chambers. Each party has their own ideas as to how this issue should be addressed and resolved. At this point, this will probably be an issue for us at Capitol Conference where I hope to see many of you!
For your information, there is a new Operation Shout system in place at NAHU. If you would like, check it out at www.nahu.org once you sign in as a member.
For those in the Medicare space, there is a new Medicare Plan Finder. In all probability, if you are very active in this arena, your IMO or GA has directed you to webinars or explanations. What NAHU wants to know is if you run into any problems or difficulties while using the site. If you do, they ask that you email them at firstname.lastname@example.org with the issue you had. This way, NAHU can aggregate these issues and speak with CMS about them.
Finally, I want everyone to start thinking about attending Capitol Conference in February. There is a good chance, that NCAHU may offer to pay for one first timers’ registration from each chapter. If you are interested, be the first to contact me.
Thank you all for being members and contributing to our association. I know I have mentioned I am there if you need me, so please feel free to reach out for help. Until next month, have a great end of summer and a strong fall!