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house Bill H.R. 5273

Reforming Medicare to Help Hospitals and Improve Enrollment Data

Argument in favor

This bipartisan legislation contains a number of straightforward fixes to Medicare that will help hospitals better serve their patients and lead to improved data reporting about Medicare enrollment.

Sherri's Opinion
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06/10/2016
It seams like the better way to take care of hospital needs.
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Grace's Opinion
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01/28/2017
Preventive and routine care saves money. We would be productive citizens if we are healthy.
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Steve's Opinion
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06/15/2016
Simplify. Simplify. Simplify. Stop thinking and acting like beauracrats.
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Argument opposed

Congress shouldn’t need to fix changes to Medicare that it made less than one year ago, and HHS should be able to terminate providers’ Medicare Advantage contracts for failing to meet any minimum standard.

Carol's Opinion
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06/27/2016
No changes to medicare, it is meant for retirees old enough to be in medicare. This is not medicaid. I don't trust any medical bill that changes anything under Obama care.
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Ben's Opinion
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10/13/2016
Get rid of government run insurance programs.
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Claude's Opinion
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03/01/2017
The expense does not justify the outcome data. This just increases administrative Burden
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What is House Bill H.R. 5273?

This bill would implement a number of reforms to Medicare’s payment system aimed at helping hospitals better serve their patients, particularly in low-income communities, in addition to updating how Medicare enrollment data is reported.

The Dept. of Health and Human Services (HHS) would be required to change the Hospital Readmissions Reduction Program to ensure that hospitals serving low-income patients aren’t penalized by being compared to hospitals with a dissimilar patientbase. Currently the calculation doesn’t account for disparities in the frequency of hospital visits by different socioeconomic groups, which punishes hospitals serving lower-income patients.

Hospital outpatient departments (HOPD) classified as “mid-build” would be required to certify that they’re provider-based to HHS, which would be responsible for auditing those claims to receive the full HOPD payment rate rather than a lower fee schedule. Essentially, this lets hospitals that were building HOPDs when a November 2015 change occurred to bill Medicare, even though current law would have otherwise prevented them from doing so.

HHS’ ability to terminate Medicare Advantage (MA) contracts based on a failure to achieve minimum quality ratings under the MA STARS rating system would be delayed for three years. The Centers for Medicare and Medicaid Services (CMS) could still terminate plans for the 10 other performance categories included in a Past Cycle Performance Review.

HHS would be required to publish Medicare enrollment data by Congressional District, zip code, and state each year. This would include MA, Part D, plus fee-for-service enrollment data, and comprehensive enrollment report for Medicare no later than June 1 of each calendar year with the preceding year’s data.

Impact

Medicare enrollees; healthcare providers — particularly hospital outpatient departments and long-term care facilities; and HHS.

Cost of House Bill H.R. 5273

The CBO estimates that implementing this bill would increase spending by $50 million over the 2017-2021 period while decreasing spending by $14 million over the 2017-2026 period.

More Information

In-Depth: Sponsoring Rep. Pat Tiberi (R-OH) introduced this bill to provide needed reforms for hospitals and other Medicare providers so as to support the development of outpatient facilities and allow hospitals to treat more low-income patients:

“The Helping Hospitals Improve Patient Care Act takes responsible steps to strengthen Medicare and give hospitals and health care providers the certainty they need to best serve their patients. It is fully paid for and includes many bipartisan provisions that are priorities to members of the Ways and Means Committee.”

The House Ways and Means Committee passed this legislation by voice vote.



Media:

Summary by Eric Revell
(Photo Credit: Flickr user VCU Libraries)

AKA

Helping Hospitals Improve Patient Care Act of 2016

Official Title

To amend title XVIII of the Social Security Act to provide for regulatory relief under the Medicare program for certain providers of services and suppliers and increased transparency in hospital coding and enrollment data, and for other purposes.

bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
      senate Committees
      Committee on Finance
  • The house Passed June 7th, 2016
    Passed by Voice Vote
      house Committees
      Committee on Energy and Commerce
      Committee on Ways and Means
      Health
    IntroducedMay 18th, 2016

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    It seams like the better way to take care of hospital needs.
    Like (7)
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    Preventive and routine care saves money. We would be productive citizens if we are healthy.
    Like (5)
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    Simplify. Simplify. Simplify. Stop thinking and acting like beauracrats.
    Like (3)
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    Please do your job. I am Medicare beneficiary--Medicare Advantage leave it alone! Unless you have a better/fairer plan. Senate...let your conscience--your own family be your guide.
    Like (2)
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    1. People that are not in the position to experience Medicare/ Medicaid on a need to have basis should not vote on this bill because although it does effect your tax dollars you will have to pay taxes regardless.
    Like (2)
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    They should go single payer, but this does make sense so not sure why all regions would be treated equally at the expense of lower income areas. Single payer is the better way to go though.
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    Paul Ryan wants to gut Medicare. I think he's too stupid to understand we who use it pay for it at over $100.00 a month. He is a rotten snake who like a rat likes to hide and sneak to do terrible stuff. If our lawmakers do not protect us older citizens who kept our bargain, such a terrible Nation will destroy itself. If you want every senior and their. Hold R.E.M. To riot everyday, just sit there and see what happens. Without my medicine, I will die. Do you think my children will be happy and re elect the people who killed us to get more money for their rich handlers???? This administration is a world wide joke. Keep your hands and Paul Ryan and Mitch McConnells dirty hands off of our money!
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    Nay, not cost effective.
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    Get rid of government run insurance programs.
    Like (1)
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    No changes to medicare, it is meant for retirees old enough to be in medicare. This is not medicaid. I don't trust any medical bill that changes anything under Obama care.
    Like (1)
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    If it can serve the patients and hospitals more efficiently, I'm in favor.
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    Medicare insures too many to trash the system. It can be fixed, if bipartisan legislation like this can pass both houses.
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    Not cost effective
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    There definitely needs to be reform.
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    Any technological advances used to improve processes in hospitals and health care facilities will be well worth the investment.
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    Too much government in everything
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    H.R. 5273 " This provision provides a bridge to improved consideration of socioeconomic status in the Hospital Readmissions Reduction Program to prevent penalizing hospitals that serve low-income patients, without masking socioeconomic disparities."
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    The expense does not justify the outcome data. This just increases administrative Burden
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    Keeping accurate records of usage is important especially for patients apt to fall through the cracks. Low income areas already suffer from having too few providers. If the information is used justly then it would be worth the extra funding.
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    It does not matter how long regulations/laws have been in effect. If it is recognized that it is fail and not performing as expected fix it.
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