To amend title XVIII of the Social Security Act to establish a definition of essential health system in statute.
Impact
If enacted, this bill would have significant implications for hospitals, particularly those classified as disproportionate share hospitals, which serve a large number of low-income patients. By establishing a clear definition, the bill aims to potentially strengthen reimbursement structures and support for these hospitals, which may face unique financial challenges due to high rates of uncompensated care. The law aims to enhance access to care in underserved communities, thereby impacting health equity on a broader scale.
Summary
House Bill 7397 seeks to amend title XVIII of the Social Security Act in order to establish a formal definition of 'essential health system'. This legislative proposal targets the standardization of what constitutes essential health services, particularly focusing on hospitals that fall under this designation. The bill specifies that an essential health system includes non-Federal governmental or private nonprofit hospitals that meet certain federal criteria based on their patient demographics and care provisions.
Contention
One notable area of contention may revolve around the eligibility criteria established in the bill. Critics may argue that the definition could inadvertently limit the number of facilities eligible for support, potentially excluding certain hospitals that do not meet the strict criteria laid out. Moreover, there could be debates regarding the impact on state and local healthcare systems that rely on flexibility to address unique community needs. This balance between federal standards and local adaptability is a crucial point of discussion as stakeholders assess the potential effects of the legislation.
To amend title XVIII of the Social Security Act to remove in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology.
To amend title XVIII of the Social Security Act to provide for the guaranteed issue of Medigap policies to all Medigap-eligible Medicare beneficiaries and Medicare Advantage enrollees, and for other purposes.
To amend title XVIII of the Social Security Act to provide for certain cognitive impairment detection in the Medicare annual wellness visit and initial preventive physical examination.
To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models under the Medicare program.
To amend title XVIII of the Social Security Act to provide for enforcement of standards for reasonable and relevant contract terms and conditions and essential retail pharmacy protections under the Medicare program.
To amend title XVIII of the Social Security Act with respect to the work geographic index for physician payments under the Medicare program, and to revise the phase-in of clinical laboratory test payment changes under such program.