This article was originally published on July 12, 2017, and updated on August 28, 2017.
For Medicare beneficiaries, and Medicaid recipients, the theme these past months has been “Much Ado About Healthcare!” First, there was the House’s introduction of the American Health Care Act (AHCA), aka Trumpcare. Then, there was the Senate’s introduction of the Better Care Reconciliation Act (BRCA). Both of these pieces of legislation focus on repealing the Affordable Care Act (ACA), aka Obamacare, and both have encountered heavy resistance.
Many organizations, from the AARP to other senior citizen advocates, have spoken out against the healthcare bills, and that’s not even including the outrage on social media. As much as the recent news that GOP Senate leaders are seeking a compromise on the legislation is soothing in comparison to the rancor thus far, Medicare patients could use some more promising news about what the government plans to do with their healthcare. And we found some for you.
Something special seems to be on the verge of taking place in Congress when it comes to healthcare and Medicare. Believe it or not, there are efforts underway in Congress, most of them bipartisan, to improve what Medicare costs, what Medicare covers, and more. We have listed several pieces of legislation that are currently being passed around Washington, D.C. Each offers a glimmer of hope for senior citizens and those who are eligible for Medicare.
Empowering Medicare Seniors to Negotiate Drug Prices Act
Senator Amy Klobuchar of Minnesota led the introduction of this piece of legislation, which seeks to give the government power to negotiate with drug companies to bring down the down the price of prescription drugs. This would make a huge difference in the costs Medicare beneficiaries pay. Prescription drugs are one of the main reasons healthcare costs keep rising, and without negotiating power there seems to be no end in sight. If put into effect, this bill could cut costs drastically for the nearly 41 million people age 65 and older who are enrolled in Medicare Part D.
Medicare Hearing Aid Coverage Act of 2017
The Medicare Hearing Aid Coverage Act of 2017, officially known as H.R. 3426, would expand Medicare coverage to include hearing aids. The proposed legislation directs the Government Accountability Office to study insurance programs that provide hearing aids and other services that help with hearing loss. Currently, only Medicare Advantage programs offer the opportunity for seniors to receive coverage for hearing aids and other services.
Medicare Part B Improvement Act of 2017
In general, the bill will help Medicare payments for home infusion services, prevent gaps in care for Medicare beneficiaries while also helping patients with chronic diseases receive easier access to treatments that they need, and help protect access to prosthetics for Medicare beneficiaries who need them. More specifically, here’s what the bill will do:
- Create a transition payment for home infusion therapies for Medicare beneficiaries to ensure there is no gap in care.
- Extend a successful pilot program that allows Medicare beneficiaries with weakened immune systems to receive care in their homes.
- Protect access to orthotics and prosthetics for Medicare beneficiaries who need them.
- Improve the accreditation process for dialysis facilities so Medicare beneficiaries with chronic kidney disease living in rural communities can more easily access the treatments they need.
- Expand the use of telehealth technologies for Medicare beneficiaries receiving dialysis in their homes.
- Put into law existing regulations to modernize Medicare’s physician self-referral laws, known as “Stark laws.”
According to the non-partisan Congressional Budget Office, this act of bipartisan legislation will reduce direct spending by $4 million between 2018 and 2027. After its approval by the House Committee on Ways and Means, the House of Representatives passed HR 3178, the Medicare Part B Improvement Act of 2017 on July 25. The next step for the bill is to be brought to the Senate for vote.
Short for “Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care,” The CHRONIC Care Act of 2017 seeks to strengthen the care and improve the health results for Medicare beneficiaries with chronic illnesses and complex needs, while also targeting Medicare payment reform. A primary focus of the bill is to expand telehealth and other services that benefit patients who are homebound. Senator Orrin Hatch of Utah is the sponsor of the bill, which was introduced in April 2017. The Senate Finance Committee held an open hearing on the bill in May and unanimously approved the legislation shortly after, with hopes to move it through the Senate later this year.
H.R. 2925 to classify wigs as durable medical equipment
Congressman Jim McGovern of Massachusetts introduced this bill in June. The primary goal of H.R. 2925 remains that of recognizing wigs as durable medical equipment (DME) and, therefore, providing coverage for them. It would amend the Medicare title of the Social Security Act to cover “medically necessary cranial prostheses” (e.g., wigs) as DME for patients with dermatology or oncology needs. It was referred to the House Ways and Means Subcommittee on Health on June 16, and still has a ways to go before being introduced on the Congressional floor.
While H.R. 3168 remains a nameless piece of legislation for now, its content is extremely substantial. By Congressman Pat Tiberi of Ohio and Congressman Sandy Levin of Michigan, the bill aims to renew Medicare Advantage’s Special Needs Plans to improve the quality of care for senior citizens with chronic illnesses. The legislation would extend Chronic Special Needs Plans (C-SNPs) and Dual Eligible Special Needs Plans (D-SNPs) for five years, while making Institutional Special Needs Plans (I-SNPs) permanent. The House Ways and Means Committee met to markup this bill on July 13.
Improving Transparency and Accuracy in Medicare Part D Drug Spending Act
Congressman Morgan Griffith of Virginia and Congressman Peter Welch of Vermont introduced the Improving Transparency and Accuracy in Medicare Part D Drug Spending Act in February 2017. The legislation would be a big boost to rural, small town and community pharmacies by making sure they receive reimbursement at the rate posted at the time prescriptions are filled. This economic benefit would ensure the pharmacies remain in business and open for their patients. Both of the bill’s sponsors claim the legislation will not raise the costs in Medicare Part D. Since its introduction, the bill has been referred to the House Ways and Means Subcommittee on Health.
Medicare Dental, Vision, and Hearing Benefit Act
As the bill’s title notes, it proposes the inclusion of dental, hearing and eye care services in Medicare. By nullifying the current exclusion on coverage of important items and services, it would expand the Medicare benefit package to include dental, vision and hearing care. The bill will also reduce the number of more serious and costly ailments by expanding covered benefits under Medicare Part B, and consisting of reasonable means of expediting the application of the bill and limiting costs. Congressman Levin introduced the Medicare Dental, Vision, and Hearing Benefit Act legislation earlier this month, and it likely won’t reach a subcommittee for review until after the August recess.
Medicare Part B Home Infusion Services Temporary Transitional Payment Act
This bipartisan bill, introduced by Congressman Tiberi of Ohio and Congressman Bill Pascrell of New Jersey, seeks to create a new transitional payment structure for those who provide home infusion services before policies signed into law in the 21st Century Cures Act take effect in 2021. Basically, it would support providers of infusion services by providing resources to keep them available to vulnerable, homebound Medicare beneficiaries. The House Ways and Means Committee met to markup the Medicare Part B Home Infusion Services Temporary Transitional Payment Act on July 13.
Medicare Orthotics and Prosthetics Improvement Act
Senator Chuck Grassley of Iowa and Senator Mark Warner of Virginia (both members of the Senate Finance Committee that advanced The CHRONIC Care Act of 2017), reintroduced this piece of bipartisan legislation in May. The Medicare Orthotics and Prosthetics Improvement Act would improve standards for orthotics and prosthetics to be covered by Medicare by applying accreditation and licensure requirements to the providers of such equipment. When we first heard about the bill, we spoke with an orthopedic surgeon who told us it would “further help to assure that devices are prescribed for medically appropriate reasons and properly fitted to the individual patient.”
Medicare Buy-in and Health Care Stabilization Act
Representative Brian Higgins of NY, along with Joe Courtney and John Larson of CT, has introduced a new bill to improve the Affordable Care Act. It’s called The Medicare Buy-in and Health Care Stabilization Act, and it would extend Medicare to those over the age of 50.
Under the proposed bill, anyone between the ages of 50 and 64 would be able to buy into Medicare, including through their employer. Medicare Advantage plans would be available as well.
Allowing middle-aged people to buy into in Medicare would lower their healthcare costs significantly. This age group tends to pay more than younger people on health insurance overall, and would pay five times more than younger people on premiums under proposed repeal and replace legislation. According to Higgins, people in this age range would save 40% from the rate of the premiums they are paying now.
Other improvements to heath care are included in the Act, such as:
- Allowing Medicare to negotiate volume discounts on prescription drugs.
- Cutting down on fraud.
- Studying cost-saving measures.
- Implementing targeted reforms to strengthen Medicare in the long-term.
Hopefully, these pieces of legislation won’t be the only ones making headlines because of their benefits for Medicare beneficiaries. As noted with each bill, there are still subcommittees and committees to pass through, in addition to other measures. With the current mania over the ACA, AHCA and BRCA, there’s a lot to wade through first before the better parts of healthcare legislation come under the spotlight. For those who don’t have the patience to wait and see what happens, you can contact your local government representatives to share your thoughts on these pieces of legislation, and others.
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