House panel hears testimony on site-neutral payments, potential for Medicaid cuts to providers

After taking aim at “loopholes” and vulnerabilities in Medicaid, lawmakers have turned their attention to legislation designed to improve the program for beneficiaries.

The House Energy and Commerce Health Subcommittee discussed four bills during a hearing meant to increase eligibility for Medicaid coverage, and improve beneficiaries’ access to care. Three of those bills had already passed the Senate prior to Friday’s hearing; a fourth bill is currently in draft form.

The bills discussed include:

  • The PACE Innovation Act, which would allow the Department of Health and Human Services to waive Medicaid requirements in order to test demonstration projects for the PACE program, including one that would allow high-need, high-cost people under the age of 55 to participate

  • The Ensuring Access to Clinical Trials Act of 2015, which would provide patients with rare diseases with up to $2,000 in compensation for clinical trial participation, without that compensation contributing to their Medicaid eligibility

  • The Special Needs Trust Fairness Act of 2015, which would allow non-elderly people with disabilities to establish a special needs trust on their own behalf. If passed, a special needs trust established by a non-elderly person would not be considered an asset when determining Medicaid eligibility.

  • The Medicaid Directory of Caregivers Act, which would require state Medicaid programs to publish an electronic directory of physician who have billed Medicaid in the prior six months. This bill has yet to be introduced.

“Given the scope of the [Medicaid] program and its impact on millions of Americans’ lives, Congress and states have a responsibility to ensure that the program is modernized to better serve some of our nation’s neediest citizens,” said Subcommittee Chairman Joseph Pitts (R-PA).