Supreme Court Upholds ACA Subsidies
Key Takeaway: In a 6-3 decision, the Supreme Court upheld the validity of tax credits used by millions of Americans to buy insurance under the Affordable Care Act (ACA.)
Why It Matters: The decision was the second in three years backing President Obama’s health-reform law. Plaintiffs in the case King v. Burwell had challenged the validity of the subsidies, arguing that only individuals in states with a state-based insurance exchange were eligible under the language in the Affordable Care Act. Last week’s decision said the 2010 ACA allows tax credits in all 50 states, not just the 16 that have authorized online insurance exchanges.
With no changes mandated by the Court, implementation of the various provision of the ACA will continue, signaling the need to move ahead with the implementation of the technology needed to execute the law.
CHIME’s interim Vice President of Public Policy made the below statement in response to the Court’s decision:
“The importance of the Supreme Court decision is the certainty that it brings to healthcare organizations to move ahead with the implementation of the technology needed to execute the provisions of the law. The Affordable Care Act shifts the conversation to quality improvement and increased value, which will not be possible without robust health IT systems able to generate the data needed to usher in the mandated delivery systems reforms.
We expect the Congressional focus on health IT to continue, as the need for interoperability and health data exchange will be imperative as health systems progress in the implementation of various ACA provisions. Health IT systems will be the tools used to measure the quality and value of care delivered by providers; IT will assist in the care coordination necessary for chronic care management and prevention; and will be the infrastructure for precision medicine.
Policymaking that capitalizes on the potential EHRs and health IT systems hold to be valuable resources to clinicians and patients is crucial as the nation pursues sincere delivery system reform.”
No Boost in Funding for ONC, Prohibition of Health Identifiers Remains in Appropriations Bills
Key Takeaway: The House and Senate both put forth appropriations bills that maintained ONC’s current funding level through FY2016, approximately $60.4 million. The bills also maintained the prohibition of a national health identifier.
Why It Matters: The President’s FY16 budget request that more than $90 million be set aside by lawmakers in the HHS budget for ONC, citing the need to focus on interoperability and meaningful use initiatives. Instead, both the House and Senate chose to maintain current funding levels for the health IT-focused agency.
The House Appropriations Committee voted 30-21 to approve legislation that would provide $153 billion in discretionary funding for the departments of Labor, Health and Human Services, Education and related agencies in fiscal year 2016, $3.7 billion less than in 2015. The House bill would terminate the Agency for Healthcare Research and Quality and rescind funding for the Center for Medicare & Medicaid Innovation.
The Senate Appropriations Committee voted 16-14 to approve legislation that would provide $153.2 billion in discretionary funding for the departments of Labor, Health and Human Services, Education and related agencies in FY 2016. The Senate legislation eliminates discretionary funding for the Affordable Care Act (ACA) and Independent Payment Advisory Board (IPAB). The bill would provide $70.4 billion for HHS programs, $646 million less than in FY 2015.
During the hearing, amendments were proposed by Senator Bill Cassidy (R-LA) to delay the implementation of ICD-10 until October 2016 and to provide hardship exemptions to eligible professional implementing ICD-10. None of the ICD-10 related amendments were included in the final text.
Notably, both bills again included the below language banning a HHS from pursuing a national health identifier:
None of the funds made available in this Act may be used to promulgate or adopt any final standard under section 1173(b) of the Social Security Act providing for, or providing for the assignment of, a unique health identifier for an individual (except in an individual’s capacity as an employer or a health care provider), until legislation is enacted specifically approving the standard.
Consider sharing your experience with your lawmakers using CHIME’s Congressional Advocacy Portal - a communication tool that enables CHIME members to directly email their Members of Congress in the House of Representatives and Senate in just a few short steps.
The House and Senate can still remove this outdated provision from the appropriations bills before final passage, thus please consider reaching out to your members of Congress today.
The funding bills are expected to reach the floors of the House and Senate for final passage before the end of July. Unless significant changes occur, President Obama is likely to veto the reconciled Labor-H funding package.
Bill to Exempt Encounters at ASCs from MU Passed by Senate Finance Committee
Key Takeaway: A bill that would exempt patient encounters that take place in ambulatory surgery centers from meaningful use requirements was cleared unanimously by the Senate Finance Committee last week.
Why It Matters: The bill would exempt encounters in ambulatory health centers from meaningful use until ONC develops these standards for EHR certification. A similar version of the Electronic Health Fairness Act, sponsored by Senators Johnny Isakson (R-GA) and Michael Bennet (D-CO), passed the House last week championed by Representative Diane Black R-TN-06).
Under current law physicians participating in the EHR incentive program must perform at least half of their outpatient encounters in a facility with a certified EHR or be subject to a penalty. However, there is no requirement that ambulatory surgery centers use EHRs, and ONC offers no certification program specifically for them.
The bill was one of 12 the Finance Committee considered last week. It is unclear when the bill will be considered by the full Senate for final passage.
Medicare Eligible Professionals: Apply for a Hardship Exemption by July 1 to Avoid 2016 Medicare Payment Adjustment
Key Takeaway: Eligible Professionals (EPs) in the meaningful use program must file an application for a hardship exemption to avoid a payment adjusted in 2016, either electronically or postmarked no later than 11:59 p.m. ET on July 1, 2015.
Why It Matters: Payment adjustments for eligible professionals that did not successfully participate in the Medicare EHR Incentive Program in 2014 will begin on January 1, 2016. Medicare eligible professionals can avoid the 2016 payment adjustment by applying for a hardship exemption before July 1.
The hardship exception applications for an individual and for multiple eligible professionals are available on the EHR Incentive Programs website. If approved, the exception is valid for the 2016 payment adjustment only.
To file a hardship exception, you must:
- Show proof of a circumstance beyond your control.
- Explicitly outline how the circumstance significantly impaired your ability to meet meaningful use.
Edited by Gabriel Perna for style purposes