March 2015

The Washington Update is prepared by Miranda Franco, Senior Public Affairs Adviser for Holland & Knight

ACCT Applauds Committee's Passage of Trauma Reauthorization

ACCT congratulates the House of Representatives Energy and Commerce Committee on its action to approve "The Trauma Systems and Regionalization of Emergency Care Reauthorization Act (HR 648)" and "The Access to Life-Saving Trauma Care for All Americans Act" (HR 647) for consideration by the House of Representatives.

"The Trauma Systems and Regionalization of Emergency Care Reauthorization Act" would among other provisions, reauthorize the Trauma and Emergency Care Systems Grants through 2020. These programs are essential to improvement of trauma systems and piloting regionalized systems of emergency care to create greater efficiency of emergency medical care and transport, as called for by the IOM.
"The Access to Life-Saving Trauma Care for All Americans Act" would among other provisions reauthorize the Trauma Care Center Grants and The Trauma Service Availability Grants through 2020. These programs would provide grants to prevent further trauma center closures and address shortfalls in trauma services and improve access to and the availability of trauma care in under-served areas.
These programs are critical to ensure the coordination of trauma care delivery among trauma centers, ambulances, helicopters, state and local governments as well as implement and evaluate innovative models of regionalized emergency care systems.
Thanks to the leadership of Dr. Burgess and Rep. Green and the tremendous efforts of ACCT and the trauma and EMS community this vote is the first step in the 114th Congress toward improving trauma care. ACCT and our advocacy partners submitted support letters to the committee in advance of the mark. To view the letters, please visit the links below:

Trauma Coalition Support letter Parts A-C 2015 MF
Trauma Coalition Support letter Parts D, F and H 2015 MF

GAO Releases Report on Shortages of Controlled Substances

ACCT worked diligently with the American College of Emergency Physicians (ACEP) to ensure the Government Accountability Office (GAO) conducted a study on the number of factors that may be contributing to the drug shortage issue, as there is debate over the reasons.
CCT providers administer life-saving care, often through the use of specialized equipment or drug therapies, while transporting a patient from the scene to a medically appropriate receiving hospital or between hospitals, typically moving patients to a higher tertiary care facility. If patients do not have access to these drugs within a very short time window, it can mean the difference between life and death or serious disability.
ACCT called for an investigation of the root causes of the shortages through congressional outreach. The report was requested by Senators Grassley (R-Iowa) and Whitehouse (D-Rhode Island). Accordingly, GAO conducted a study to examine the cause of drug shortages and provide recommendations on how to alleviate such shortages. The report may be viewed here.

Supreme Court Hears Oral Arguments for King v. Burwell

On March 4, the Supreme Court heard oral arguments for King v. Burwell, a case challenging the subsidies available to individuals on federally-facilitated ACA health insurance exchanges. This challenge is not about a violation of the Constitution; it is about how to interpret a law created by Congress.
This case hinges on five words: exchange established by the state. The petitioners (or challengers) believe that the Patient Protection and Affordable Care Act (ACA) only permits subsidies for exchanges established and run by the state.
When the ACA was implemented, sixteen states created their own exchanges. There is no dispute that consumers who purchase health insurance in those states are eligible for subsidies. However, the other thirty-four states chose not to set up an exchange and, under the ACA, the federal government set up exchanges for each of those states. The petitioners' view is that subsidies are not available to those thirty-four states because Congress said what it meant - "established by the state". The Supreme Court is expected to deliver its decision by the end of June.

White House Releases FY 2016 Budget Proposal

On February 2, 2015, President Obama released his Fiscal Year (FY) 2016 Budget. The President's budget proposal would use federal savings and revenues to reduce the deficit, replace sequestration of Medicare and other federal programs for 2016 through 2025, and pay for new spending priorities.
The President's fiscal blueprint, for the budget year that begins Oct. 1, 2015, proposes spending $4 trillion and projects revenues of $3.53 trillion, leaving a deficit of $474 billion. The budget request exceeds the spending caps established in 2010 by $74 billion spread evenly between military and non-military discretionary spending. The Administration is proposing offsets to cover some of the expanded spending ($1.8 trillion over a 10-year period). To view the health and CCT provisions in the budget, please click the links below.
FY 2015 President's Budget Proposal EMS.pdf
FY2016 President's Health Budget FINAL.pdf

Implementation of ICD-10 is on Track

The House Energy and Commerce Committee Subcommittee on Health held a hearing last week to discuss a Government Accountability Office (GAO) report that outlines the progress and activity of the CMS in preparing to implement the tenth revision of the International Classification of Diseases (ICD-10) on October 1, 2015. The vast majority of committee members were supportive of transitioning to ICD-10 on the current schedule.
All medical claims submitted by health care providers to payers, both public and private, for reimbursement have an ICD code. Currently, the ninth revision is in use in the United States. The transition to the 10th revision is scheduled to take effect on October 1, 2015, after twice being delayed for one year. ICD-10 provides more specificity in labeling patient diagnoses and in categorizing inpatient procedures.

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