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Cutting Red Tape in Medicare to Help All Communities

September 24, 2018

In pursuit of moving to a value-based, patient-centered, and highly coordinated health care system, the Ways and Means Health Subcommittee, chaired by Rep. Peter Roskam (R-IL), in July 2017 began the “Medicare Red Tape Relief Project.”

Through this initiative, Committee Members have worked to identify opportunities lawmakers and the Administration can pursue to reduce legislative and regulatory burdens on Medicare providers, improving the efficiency and quality of the Medicare program for seniors and individuals with disabilities.

This week, as part of this Project, Chairman Roskam and Rep. Adrian Smith (R-NE) wrote to the Centers for Medicare and Medicaid Services (CMS) stressing how cutting red tape will benefit rural communities.

The lawmakers wrote in support of action CMS has already taken to reduce excessive regulations and administrative burdens, and highlighted areas where further improvements can be implemented:

“We appreciate the work CMS has done to make improvements in the enforcement of the direct supervision requirement for outpatient therapy services at rural hospitals and the modified enforcement of the 96-hour requirement for Critical Access Hospitals (CAHs). We urge CMS to continue such policies in future years. We also encourage CMS to provide flexibility for co-location of providers in order to improve access to care in rural areas. Lastly, we urge CMS to make improvements to the hospital compare website to reduce confusion for beneficiaries trying to access information about rural hospitals.”

(CLICK HERE to read the full letter.)

As the Ways and Means Committee and the Administration continue our work to help patients nationwide, here is a brief guide to the Medicare Red Tape Relief project.

The Red Tape Relief Project has had three stages:

Stage One: Request feedback from stakeholders to learn more about the policies that improve health care – and the policies that stand in the way of caring for patients.

Upon announcing this initiative, the Subcommittee asked stakeholders to submit comments on the burdens they face in offering their patients quality care due to Washington’s excessive rules.

Over 330 providers, health care, and advocacy groups responded and identified areas in the Medicare program that are getting in the way and adding unnecessary costs for patient care.

Stage Two: Host roundtables with stakeholders to continue the conversation and identify solutions.

Chairman Roskam and the Health Subcommittee hosted a series of roundtables this year with hospitalspost-acute care providers, physicians, and other medical professionals that were focused on how lawmakers and the Administration can work to cut red tape in the Medicare program to help these groups provide better care to their patients. 

Stage Three: Take Congressional action based on feedback from stakeholders and dialogue with the Administration.

The Health Subcommittee held a hearing discussing the need to modernize Stark Law and has actively engaged with the Centers for Medicare and Medicaid Services (CMS) and Department of Health and Human Services (HHS), who have also asked stakeholders to identify regulatory action the Administration should take to reduce red tape through their “Patients over Paperwork” initiative.

The Subcommittee has also acted upon the findings from stakeholders and hearings by:

  • Exchanging information with stakeholders and the Administration;
  • Applauding CMS for taking steps to reduce provider burdenand urging the Agency to take additional action through ongoing conversations and public letters; and
  • Legislative solutions.

This is in addition to the meaningful work Congress has already done to reduce red tape in Medicare.

For example, last Congress H.R. 3831, the Securing Fairness in Regulatory Timing Act of 2015, introduced by House Ways and Means Chairman Kevin Brady (R-TX), was signed into law. This law gives stakeholders long-overdue relief and allows for additional time for stakeholders to review and comment on Medicare Advantage and Part D regulations beginning in 2018.

Also, as part of the Bipartisan Budget Act of 2018, several policies were signed into law addressing issues that had received significant stakeholder comment, including:

  • H.R. 3120, to reduce annual burdens under the meaningful use program, which was statutorily required to become more stringent every year.
  • H.R. 3178, the Medicare Part B Improvement Act of 2017, which included several provisions:
    • H.R. 3171, which streamlined rules to protect patients’ access to prosthetics for patients who need them;
    • H.R. 3166, which removed regulatory burdens in accreditation for dialysis facilities to expand access for vulnerable patients;
    • H.R. 3164, which expanded the availability of telehealth for patients receiving dialysis in their homes; and
    • H.R. 3173, which codified important flexibilities to modernize the physician self-referral, or Stark Law.
  • H.R. 4987, which made several key technical corrections to the changes made by MACRA to the physician payment system to provide flexibility to CMS to lower physician burden.
  • H.R. 1148, which expanded access to telehealth services for providers serving patients that have suffered a stroke.
  • Provisions found in H.R. 2663, which allowed CMS to consider the entire patient’s record when deciding if a patient is eligible for home health care services, thus ensuring that the patient’s condition and status is fully understood while reducing burden for the home health agency and physician.

Working together with providers and the Administration, the Subcommittee is leading the way to help refocus our health care system on what matters most: patients’ needs.

Chairman Roskam and the Ways and Means Committee look forward to producing additional legislation for the Committee to approve as we strive to ensure Medicare works on behalf of patients and providers.