The U.S. Congress returned last week to try to wrap up its work before the newly elected Congress is sworn in next month. This return \u2013 known as the \u201clame-duck\u201d session \u2013 has important topics on its to-do list. Among the most critical items is to try to agree on funding for the federal government \u2013 at least through the winter \u2013 providing more disaster aid, approving a defense policy bill, confirming judges, and hopefully, taking on some important health care measures.<\/p>\n\n\n\n
The term \u201clame-duck\u201d session of Congress refers to the period when the Congress meets after its successor is elected, but before the successor’s term begins. And that period is now.<\/p>\n\n\n\n
The most important action for the lame-duck is for Congress to approve continued government funding<\/a>, since lawmakers only have until December 20th<\/sup> before the existing funding runs out. Passing a budget was not the first item to be tackled, however. The U.S. Senate leadership agreed to a deal<\/a> to allow confirmation of some of President Biden\u2019s judicial nominees. <\/p>\n\n\n\n Top issues are replenishing the Federal Emergency Management Agency<\/a>\u2019s disaster relief fund and agreeing on funding<\/a> of the defense department, with other potential topics including measures that impact health policy.<\/p>\n\n\n\n While it remains to be seen how much legislative activity occurs during the lame-duck, one of the possibilities is a measure known as \u201csite neutral\u201d<\/a> health care payments.<\/a> <\/p>\n\n\n\n Last month, nearly 60 organizations joined the call to urge<\/a> Congress to pass legislation that would require that hospital and non-hospital Medicare pricing be the same. <\/p>\n\n\n\n Here is the background: The amount charged for medical procedures or services can depend as much on where<\/em> they are performed as on the type of procedure or service provided. All else being equal, a procedure in a hospital is much more expensive than that same procedure done in a freestanding facility like a physician\u2019s office or a clinic. The higher cost is meant to support a hospital\u2019s more complex infrastructure, staffing and other expenses. <\/p>\n\n\n\n However, these higher prices are being charged for services provided at non-hospital locations, which often operate at less expense.<\/em> That\u2019s in large part because hospitals are buying up private practices, clinics, imaging centers and labs, using them effectively as a \u201ccash cow” to charge more. Once acquired, these facilities often begin using the hospital billing code to charge hospital prices for services that were previously less expensive. When acquired by a hospital, physician practices charge<\/a> about 14 percent more than when they were independent. That means patients and insurers begin to pay more for the same service. The only difference is that the non-hospital facility is owned by a hospital and begins to use the hospital billing code. And over half of physicians now work<\/a> for hospitals and health systems. <\/p>\n\n\n\n As a result, patients, Medicare, and employer-based insurance companies are paying much higher prices for care than they otherwise would. For example, Medicare pays<\/a> twice <\/em>as much for procedures done in hospital-owned facilities as they would in independent physician\u2019s offices. Don\u2019t forget that for many patients, high deductibles and co-insurance policies mean that they<\/em> may face a financial hit as well. <\/p>\n\n\n\n The \u201csite neutral\u201d legislation that would be considered in the lame-duck requires that Medicare procedures and services are delivered at the same price regardless of the location, whether it\u2019s a hospital, doctor\u2019s office, imaging center or clinic. This would save significant money for consumers, employers and taxpayers. Decreased Medicare spending as a result of \u201csite neutral\u201d policies could save<\/a> taxpayers $150 billion.<\/p>\n\n\n\n Those savings drove the House of Representatives to approve legislation<\/a> that contained a \u201csite neutral\u201d provision. In the U.S. Senate, Republican Senator Cassidy and Democratic Senator Hassan have released<\/a> a legislative framework for \u201csite neutral\u201d payment policy. Their proposal could be the vehicle for action during the lame-duck.<\/p>\n\n\n\n Of course, whatever happens during the lame-duck will have to be the product of bipartisan compromise. Given the existing narrow Democratic Senate majority, which is soon to be replaced by a Republican one, the parties will have to agree to get anything<\/em> done at all.<\/p>\n\n\n\n Yet, the bipartisan nature of the Cassidy\/Hassan plan, coupled with the apparent support in the House, indicates \u201csite neutral\u201d legislation has a chance. The prospects for success hinge on whether it\u2019s a priority of current Senate Majority Leader Schumer. Here\u2019s hoping he\u2019s able to get it done.<\/p>\n","protected":false},"excerpt":{"rendered":" The U.S. Congress returned last week to try to wrap up its work before the newly elected Congress is sworn in next month. This return \u2013 known as the \u201clame-duck\u201d session \u2013 has important topics on its to-do list. Among the most critical items is to try to agree on funding for the federal government […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3124","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/posts\/3124","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/comments?post=3124"}],"version-history":[{"count":1,"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/posts\/3124\/revisions"}],"predecessor-version":[{"id":3125,"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/posts\/3124\/revisions\/3125"}],"wp:attachment":[{"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/media?parent=3124"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/categories?post=3124"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/tags?post=3124"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}