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Report: Bill to Fight Zika Could Strip HHS of MACRA Funds

May 25, 2016
by Rajiv Leventhal
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With a House bill providing money to fight the Zika virus pending, the Department of Health and Human Services (HHS) may be stripped of funds that it was planning to use for Medicare Access and CHIP Reauthorization Act (MACRA) information technology provisions, according to a Morning Consult report.

The report references a letter it obtained from HHS that said the agency plans to use $108 million of its “Nonrecurring Expenses Fund” to invest in “the development of information technology and other systems needed to effectively implement several provisions of MACRA.”

Specifically, the monies would be used to remove all Social Security Numbers from Medicare cards, as well as design and implement the value-based purchasing IT system needed to implement the Merit-Based Incentive Payments (MIPS) and Alternative Payment Models (APMs), different payment systems for how eligible Medicare providers would be reimbursed under the new law. Improvements to Medicare and Medicaid IT systems and cybersecurity enhancements would also be part of the $108 million used, the letter stated.

Last week, the House voted 241-184 to pass a bill that would provide $622 million to combat the Zika virus—about half the amount of a Senate measure, and about $1 billion short of the White House's funding request. The House bill would fund U.S. response efforts through September and would mandate that the funding be offset by spending cuts in other areas. However, the Senate measure would finance Zika efforts through Sept. 30, 2017, and would not require offsetting cuts, according to news reports.

As such, the Nonrecurring Expenses Fund, along with leftover money to fight the Ebola virus, is used to pay for the House’s Zika bill, according to a House appropriations aide, per Morning Consult’s report. But, HHS has already planned to use the money, $230 million in sum, for MACRA implementations and other investments such as the Indian Health Service (IHS).

The report continues, “Yet if the House version of the Zika bill passes, that $230 million could be taken away to offset the cost of fighting the virus.” It says that “HHS sent the letter about using it for MACRA after the Zika bill included language to rescind some of it. In theory, there is money left over in the fund for MACRA and other HHS goals, but it’s not clear what other plans HHS has for the remainder.”

The Obama administration has asked for $1.9 billion in funding to fight Zika, and the Senate has negotiated a bipartisan bill that would give $1.1 billion, the report said.

“This legislation will make dollars available to fight the disease now, prioritizing critical activities that must begin immediately, such as vaccine development and mosquito control. The legislation funds these efforts in a responsible way, using existing resources—including excess funding left over from the Ebola outbreak—to pay for it,” said House Appropriations Chairman Hal Rogers (R-Ky.) when the bill was introduced earlier in May.

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