The House Education and Workforce Committee is adding to the bipartisan scrutiny of hospitals tomorrow with a markup of legislation that aims to crack down on anti-competitive practices and allow for more flexible contracts.
Why it matters: It's another sign of Congress' willingness to target practices that critics argue are enriching facilities and raising prices for patients, Victoria reports.
- Site-neutral payment policies have dominated the discussion during the 118th Congress, but there's growing interest at the committee level in addressing hospital consolidation and market power.
What's inside: Education and Workforce is considering the Healthy Competition for Better Care Act from Rep. Michelle Steel (which we reported on first last year), along with legislation addressing certain telehealth facility fees.
- Steel's bill would give insurers and employers more discretion to enter into contracts with the hospitals and providers, without being forced to enter into an agreement with all the affiliated facilities in a health system.
- The legislation would allow for more flexible contracting arrangements, including having insurers negotiate their own rates with providers who aren't in-network.
- A separate bill from Rep. Aaron Bean that's on the agenda would ban facility fees and other payments added for telehealth services under ERISA.
Between the lines: The ERISA Industry Group, which represents employers with benefit plans, told Victoria that it supports the contracting bill, noting that businesses "have been concerned for decades about health system consolidation and limited access to certain provider groups."
- But hospital groups are lined up in opposition. The changes will "further empower wealthy commercial insurance companies at the expense of patients," Jason Kleinman, director of federal relations at the American Hospital Association, said in a statement.
Flashback: A primary care and health workforce package that the Senate HELP Committee approved last September included a provision that would have banned anti-competitive terms in contracting, as well as language to curb certain hospital facility fees, including for telehealth services.
- Most of the committee's Republicans opposed the package on the grounds its cost was not completely offset, among other issues.
But the legislation could be a potential cost-saver in a bigger health deal: CBO estimated that the contracting and facility fee measures in the Senate HELP package would generate about $5 billion in added revenue over a decade.
