Capitol Hill Update: HR 2869–Medicare Patient Access to Treatment Act
By Sydney Abbott, JD, Manager, Provider Economics and Public Policy, ACCC
The Medicare Patient Access to Cancer Treatment Act of 2013, HR 2869, was recently introduced by Representative Mike Rogers (R-MI). The bill would equalize Medicare payments between the hospital outpatient department (HOPD) and the physician office setting for chemotherapy administration. Because the legislation calls for budget neutrality, the bill proposes to increase physician office setting reimbursement while decreasing the hospital outpatient department payments. The legislation leaves the mechanics of reimbursement equalization to the Secretary of Health and Human Services.
HR 2869 is largely based on the findings of studies showing care is increasingly provided in the HOPD as a result of hospitals purchasing physician practices. The legislation cites the savings of the 340B Program and Medicare bad debt reimbursement to hospitals as reasons why payment should be the same between the settings. However, the bill does not address the other costs hospitals incur that are not present in the physician office setting, such as higher overhead or the fact that hospitals often treat patients who require more complex services than are available in the physician office setting. ACCC is working with Representatives Mike Rogers (sponsor) and Doris Matsui (D-CA) (original co-sponsor) to educate them on the full implications of this legislation.
HR 2869 is co-sponsored by Representatives Doris Matsui (D-CA) and Trey Radel (R-FL). It has been assigned to the House Energy & Commerce and Ways & Means Committees for further review. ACCC will continue to follow this legislation closely and will update members on any developments.