HR 2863, the Preventing Hospital Overbilling of Medicare Act, requires hospitals with off-campus outpatient departments (clinics not on the main hospital campus) to bill Medicare using a separate unique identifier for those locations starting January 1, 2024. It eliminates exceptions that previously allowed hospitals to bill higher rates for services provided at these off-campus sites, mandating that all claims for such services use specific billing formats (HIPAA 837P or CMS 1500) with the new identifier. This directly affects hospitals operating off-campus clinics that serve Medicare patients, ensuring they cannot overbill Medicare by misclassifying these locations as on-campus services. The bill standardizes billing practices to prevent inaccurate charges and aligns with existing Medicare payment rules for off-campus care.
HR 2860, the "Restoring Rights of Physicians to Own Hospitals Act," removes restrictions preventing physicians from owning hospitals under specific circumstances. It amends Section 1877 of the Social Security Act to repeal requirements that barred physician ownership in rural healthcare settings and hospital exception programs. This change directly affects physicians seeking to own hospitals, particularly in rural areas where ownership was previously restricted. The bill’s key mechanism is the deletion of specific subsections (d)(2)(C), (d)(3)(D), and (i) that created these prohibitions. The policy change simplifies ownership rules for physicians without altering broader Medicare payment structures.
The Border Reinforcement Act of 2023 requires the immediate resumption of border wall construction along the US-Mexico border using previously allocated funds, with annual goals to complete 200 miles of wall until operational control is achieved. It mandates a comprehensive 5-year technology investment plan for border security systems, including surveillance and detection technology, and sets staffing requirements for U.S. Border Patrol, including a target of 22,000 full-time equivalent agents by 2025. The bill also requires U.S. Customs and Border Protection to publish monthly operational statistics on border encounters, drug seizures, and other border security metrics. Additionally, it includes provisions for DNA collection at land borders, eradication of certain vegetation impeding border security, and a report on Mexican cartels as potential foreign terrorist organizations.
HR 2769, the "Stop Penalizing Working Seniors Act," allows seniors over 65 who are enrolled only in Medicare Part A (hospital insurance) to contribute to Health Savings Accounts (HSAs). It removes a current tax rule that barred these seniors from HSA contributions while they remain working. The bill amends the Internal Revenue Code to exclude this group from the existing restriction, effective for taxable years beginning after December 31, 2022. This change directly affects working seniors with limited Medicare coverage who previously could not use HSAs for medical expenses.
This bill establishes a new workplace violence prevention standard for healthcare and social service workers. It requires employers in covered facilities - including hospitals, nursing homes, mental health clinics, and social service settings - to develop and implement comprehensive prevention plans with specific requirements. These plans must include risk assessments, hazard prevention measures, employee training on violence prevention, and procedures for reporting and investigating violent incidents. The bill also amends Medicare regulations to require compliance with these standards for hospitals and skilled nursing facilities receiving Medicare funds.
The PROTECT 340B Act of 2023 prohibits pharmacy benefit managers (PBMs), health insurance plans, and health insurance issuers from discriminating against healthcare providers participating in the 340B drug pricing program. It specifically bans these entities from paying less for 340B drugs than they would for similar drugs dispensed by non-340B providers, imposing special requirements on 340B providers, or requiring identification of 340B drugs in billing. The bill establishes civil penalties of up to $5,000 per violation per day for PBMs that violate these protections and requires the Health Resources and Services Administration to create implementing regulations. It directly affects safety-net hospitals, clinics, and health centers that serve low-income patients, particularly those in rural areas, by protecting their ability to use 340B drug discounts to provide affordable care.
HR 2474, the "Strengthening Medicare for Patients and Providers Act," changes how Medicare pays physicians for services. It replaces the previous two-part payment system (used through 2025) with a single annual payment rate update starting in 2024. This update will be based on the Medicare Economic Index (MEI), which tracks costs for medical providers. The change directly affects Medicare-certified doctors and clinics who receive payments under the physician fee schedule.
This bill would require Medicare to cover FDA-approved blood tests that screen for multiple cancers simultaneously (like breast, lung, or colorectal cancer) for beneficiaries. It directly affects Medicare recipients aged 65+ who could access these new screenings once per year, without prior authorization. The key provision adds "multi-cancer early detection screening tests" to Medicare's covered services under Part B, defining them as blood tests analyzing cell-free DNA, while maintaining existing coverage for standard screenings like mammograms. The bill does not change current coverage for individual cancer screenings but ensures Medicare keeps pace with new medical technology.
HR 1769, the Healthcare Freedom Act of 2023, amends the tax code to rename "health savings accounts" as "health freedom accounts" and expands their use. It allows individuals to use these accounts for direct primary care, health care sharing ministries, and medical cost sharing organizations, increases annual contribution limits to $12,000 (or $24,000 for joint returns), and permits rollovers between accounts within 60 days. Employers may contribute to these accounts for employees hired after a 5-year transition period, with those contributions excluded from taxable income. The bill directly affects individuals using these accounts, employers offering them, and the IRS in tax administration, without changing health insurance coverage requirements.
This bill expands Medicare Part B coverage to include specific pharmacist services, directly affecting Medicare beneficiaries and pharmacists who provide these services. It adds new coverage for pharmacist evaluations and treatments related to certain illnesses (like COVID-19, flu, or strep throat) and public health emergencies, requiring payment at 80% of the lesser of actual charge or 85% of physician payment rates (100% during emergencies). The bill also prohibits balance billing for these services, ensuring beneficiaries pay only the standard Medicare copayment. These changes aim to improve access to pharmacist care during health crises while aligning payment with existing physician service frameworks.
The Emergency Care Improvement Act would permanently allow freestanding emergency centers (FECs) to receive Medicare and Medicaid reimbursement for emergency services. FECs are independently licensed facilities operating 24/7 with on-site physicians, providing emergency care equivalent to hospital-based emergency rooms. The bill sets payment rates for FECs equal to hospital outpatient department rates for higher-level emergency services, based on existing Medicare payment structures. This change would apply to over 110 FECs, mostly in Texas, which previously operated under a temporary pandemic waiver and demonstrated 21.8% cost savings to Medicare for similar care.
HR 1666 extends deadlines for ambulance service reimbursement rules under Medicare. It amends Section 1834(l) of the Social Security Act by changing dates from 2025 to 2028 in two specific provisions: paragraph (12)(A) and paragraph (13)(A). This delay gives ambulance providers additional time to adjust to existing Medicare payment rules. The bill directly affects Medicare-certified ambulance services and the patients relying on ground ambulance care covered by Medicare.
