AAOS May 1, 2018
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Ways and Means Committee Talks Health Care Innovation

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House of Representatives Legislative Activities

Senate Legislative Activities

Ways and Means Committee Talks Health Care Innovation

On April 26, 2018, the Ways and Means Health Subcommittee discussed innovations in the health care sector and how such innovations can be used to improve and modernize the Medicare program. Subcommittee Chairman Pete Roskam (R-IL) opened the hearing, emphasizing the importance of “implementing policies that open the door to potentially life-saving devices, drugs, and delivery methods,” and urged members and witnesses to identify legislative and regulatory reforms that can help Medicare “benefit from pioneer ideas.”

“In the Medicare program, many of these cutting-edge ideas have failed to be used to their full potential,” stated Roskam. “In turn, our seniors are not able to benefit from greater efficiency, access and increased positive outcomes in receiving health care… Whether it is providing access to better, more holistic treatments or increasing efficiencies that inevitably lower costs, I am truly excited to hear from our witnesses on how they can help both improve and modernize the Medicare program and in turn increase its sustainability. The lesson we hope to learn here will be how Congress can help.  Can we help both advance and expand upon these front-line advancements, while also leading to a new wave of innovators unleashed on the status-quo?”

Roskam and others stated support during the hearing for “value-based transformation” efforts but also are looking to review current laws involving telehealth, fraud and abuse, and the 340B program that may be inadvertently impeding competition and innovation. Rep. Patrick Meehan (R-PA) questioned whether Stark and Anti-Kickback laws may be restricting care coordination efforts, and witnesses detailed how the current fraud and abuse framework is a “relic” of the fee-for-service (FFS) system that needs to be updated in light of new payment and delivery models. Rep. Adrian Smith (R-NE) urged the witnesses to identify specific telemedicine policies – such as revising current Medicare coverage restrictions – that can facilitate broader use of telemedicine among Medicare beneficiaries, particularly for long-term care in rural areas.

Witnesses representing a range of health technology or innovation-focused companies discussed recent innovations in the health care sector – such as new remote monitoring technologies – and how such innovations can be utilized in the Medicare program. The witnesses also identified current legislative and regulatory barriers that impede competition and increase spending in Medicare. One witness noted, for example, that “hospitals as we know them are obsolete,” and criticized Medicare reimbursement rules that provide an advantage to hospitals at the expense of independent practices. Former CMMI Deputy Director and current Aledade Chief Administrative and Performance Officer Sean Cavanaugh specifically encouraged the Subcommittee to examine factors that may be driving hospital-independent practice consolidation, including the 340B program and the facility fee model.

Watch the hearing online here.