On May 23, 2019, the Senate Health, Education, Labor, and Pensions (HELP) Committee released a discussion draft on legislation that would address healthcare costs, patient financial responsibility, surprise medical bills, and public health. The Lower Health Care Costs Act of 2019 aims to improve the overall patient experience of care while cutting down on out-of-pocket patient spending.

The Center for Medicare and Medicaid Innovation (CMMI) Emergency Triage, Treat, and Transport (ET3) Model is a voluntary, five-year payment model intended to provide greater flexibility to ambulance care teams to address emergency health care needs of Medicare beneficiaries following a 911 call. The anticipated start date is January 2020. 

Concerned about rising health care costs and cost differences between sites of care for the same procedures, the U.S. Congress and the Centers for Medicare and Medicaid Services (CMS) in recent years have begun implementing legislation and regulatory policies that would lower reimbursement for certain off-campus HOPDs to a level comparable with freestanding and/or non-hospital facilities. 

On March 11, 2019, President Donald Trump released his administration’s Fiscal Year 2020 budget request. The proposal asks for $2.7 trillion in spending cuts, a higher proposed reduction than any other administration in history.

 On September 18, 2018, a bipartisan group of six Senators introduced draft legislation that would limit health care providers’ ability to send patients “surprise bills” – unexpected out-of-network charges that can leave patients with substantial medical bills not covered by insurance. 

 On September 20, 2018, CMS issued a proposed rule that, if implemented, would no longer require that ambulatory surgical centers (ASCs) have a written transfer agreement with a hospital or ensure that all physicians performing surgery in the facility have admitting privileges in a hospital that meets certain Medicare requirements. 

On September 27, 2018, the House passed the FY 2019 Defense and Labor-HHS-Education “minibus” spending bill that includes a total of $90.5 billion for HHS, an increase in agency funding of $2.3 billion above FY 2018 levels. The bill, passed by a vote of 361-61, now heads to President Donald Trump’s desk ahead of the new fiscal year, which begins October 1. 

 As Congress scrambles to fund the government and avoid another shutdown, a little-known federal provision could make or break the medical marijuana industry. 

 The Pandemic and All-Hazards Preparedness Act (PAHPRA) of 2006 (Pub. L. 109-417) was developed in response to reports that federal programs created in the aftermath of September 11 and the anthrax mailing attacks still left communities unprepared to deal with public health emergencies. PAHPRA created new public health programs, and consolidated existing programs, under the authority of the Secretary of Health & Human Services and a newly created Assistant Secretary for Preparedness and Response (ASPR). 

 The CREATES Act is intended to prevent pharmaceutical companies from blocking companies from producing generic drugs by refusing to sell drugs to the new companies or taking advantage of safety regulation to block new drugs. 

On April 15, 2016, the Food and Drug Administration (FDA) released three new draft guidance documents intending to clarify lingering questions surrounding the application and the enforcement of sections 503A and 503B of the Federal Food, Drug, and Cosmetic Act (FD&C Act or Act) that regulate the practice of pharmacy compounding. 

The Balanced Budget Act of 1997 (P.L. 105-33), Section 4541(c) [42 USC Sec. 1395l(g)(1)], applies annual, per-beneficiary financial limitations on expenses considered incurred for outpatient therapy services under Medicare Part B, commonly referred to as “therapy caps.” The limits are based on incurred expenses and included applicable deductibles and coinsurance.