The Top 5 Healthcare Legislation Trends in 2020
Did you know there were 1,145 proposed bills of federal healthcare legislation at the beginning of this year? How exactly does anyone keep track of them all?
Some suggested ways you can track legislation include:
• Following organizations that influence legislation;
• Following committees that review recommendations for legislation; and,
• Revisiting legislation from the previous year.
Even though healthcare is bipartisan and the viewpoint of a political party in position influences the passing of a bill; sometimes legislators surprise constituents by sponsoring their concerns. Before the Coronavirus (COVID-19) pandemic, the Democratic Presidential candidate debates focused heavily on healthcare. And the pressing issues of access to and cost of healthcare were discussed. The top five healthcare trends continuing from these issues include:
- Billing Transparency. In 2019, a bipartisan bill that proposed transparency in hospital billing did not pass in session. Typically, bills that have been introduced in the past have a higher chance of being introduced in the future. However, an executive order, which is a directive and not legislation, proposed two rules to eliminate “surprise billing” and promote “shoppable services” advantage to patients.
a. The Publishing of Prices Online Rule. Outpatient Prospective Payment System (OPPS), a division of Medicare, that determines the reimbursement rate for outpatient services for patients is required to publishing their prices online. This allows the comparison to Ambulatory surgical center costs.
b. The Transparency in Coverage Proposed Rule. We will soon see outcomes from these rules, as well as new regulations tailored around them. Creating transparency and understanding how hospital billing and insurance bill coverage works can help the public be more informed to make healthcare decisions.
- Access to Care. Roughly 19% of Americans live in rural communities. These communities are known to have hospital closures, lack of transportation, and cost of health care services which influences residents’ access to all levels of care Another barrier is the rise of physicians pursuing specialties contributing to fewer physicians going into primary care. The proposed legislation will likely take a multi-pronged approach to support rural hospitals with federal funding, incentivizing primary care physician placement, and expanding telehealth to meet this demand. However, nearly one-fourth of this population lack access to internet services. This issue continues to be addressed on a state level, and the federal government will likely make recommendations.
- Prescription Drug Costs. We are all aware of the rising cost of prescriptions and the challenges patients have accessing brand name medications when necessary. Several proposals were made throughout 2019. In December, the Elijah E. Cummings Lower Drug Costs Now Act was passed in the House. The bill caps the price that pharmaceutical companies can set for their medications. The caps will be different for Medicare vs non-Medicare patients. The bill was presented to the Senate mid-December for further editing and voting. To date, no actions have been made by the Senate.
- Medical Marijuana. As multiple states legalized the use of marijuana-based products, marijuana remains listed as a Schedule I drug. This means that the addictive ingredient, cannabinoid, remains illegal on the federal level, and research to determining benefits using federal funding is not allowed. Many states, including Georgia, have passed bills requesting the federal government to change marijuana to a Schedule II class drug. This would allow organizations like the Centers for Disease Control and Prevention to conduct controlled research trials on the effects and interactions of marijuana. It would also make it permissible for people to access cannabinoid oil for medicinal purposes in states where it is illegal.
- Full Practice Authority (FPA) for Nurse Practitioners (NPs). The American Medical Association and the Physicians for Patient Protection confirmed their decision to require physician oversight for nurse practitioners. Currently, 23 states and two territories having FPA, and the literature continues to support that that NPs provide quality care with effective outcomes. As the primary care physician shortage grows, the need for NPs to fill the gap rises. The current federal administration continues to recommend lifting restricted practice laws permitting FPA across the nation. The American Association of Nurse Practitioners has applauded these recommendations and continues to uphold that FPA for NPs will decrease the cost of healthcare and increase access to healthcare for all Americans. Removal of restrictive laws would make it easier for NPs to serve in primary care as well as rural communities.
To continue to track and contribute to the improvement in your state and local community, be sure to join your state-led organization as well as establishing relationships with your legislators.
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Opinions expressed by NPSM contributors are their own.