The 114th Congress returned Nov. 14 for its final weeks of the session. At the top of the agenda – keeping the federal government open past Dec. 9 when current funding runs out.

In their remaining time in Washington, the AHA urges legislators to support “crucial must-pass legislation” for hospitals and health systems.

The AHA-backed legislation includes addressing the consequences of the 2015 Bipartisan Budget Act on Medicare outpatient payment to provider-based clinics that were under development at the time of the law’s passage; establishing a socioeconomic adjustment in the Medicare readmissions program; extending the Rural Community Hospital (RCH) Demonstration program; providing “25% Rule” relief for long-term care hospitals; and ensuring flexibility in physician supervision for critical access hospitals.

Each issue has been included in legislation introduced during this session and some have already passed one body of Congress.

As part of its efforts to advance hospitals’ legislative agenda, the AHA will host a Dec. 6 Advocacy Day briefing for hospital and health system leaders in Washington, D.C. Following the briefing, AHA members will take their case for passing hospital legislation to their legislators and staff on Capitol Hill.


House passes EMS bill. In related developments, the House Nov. 14 approved AHA-supported legislation, H.R. 4365, clarifying that emergency medical services (EMS) practitioners may administer controlled substances in accordance with a standing order issued by a physician medical director of an EMS agency.

“We applaud your efforts to clarify the role of standing orders while protecting the continuity of existing EMS operations and oversight structures around the country,” AHA Executive Vice President Tom Nickels said in a letter to the bill’s bipartisan sponsors and the committees of jurisdiction. “We also appreciate that the legislation continues to allow hospital-based EMS agencies to use their hospital’s Drug Enforcement Administration registration so that no new administrative burdens are placed on hospital-based EMS agencies.”


Enact EHR meaningful use flexibility.As Congress considers year-end legislation, the AHA also reiterated its support for the Electronic Health Record (EHR) Regulatory Relief Act, S. 3173, in a Nov. 14 letter to leaders of the Senate Finance, House Ways and Means, and House Energy and Commerce committees.

Introduced in July by Sens. John Thune, R-S.D., Lamar Alexander, R-Tenn., Mike Enzi, R-Wyo., Pat Roberts, R-Kan., Richard Burr, R-N.C., and Bill Cassidy, R-La., the legislation would provide regulatory flexibility and hardship relief to hospitals and eligible professionals in the Medicare and Medicaid EHR Incentive Programs.

The bill would require eligible hospitals and professionals to meet no more than 70% of the required metrics to satisfy meaningful use requirements; codify the 90-day reporting period for reporting year 2016; and extend the ability to apply for a hardship exception through 2017.

The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) also calls for greater flexibility in how physicians and other eligible clinicians are expected to use certified technology to support clinical care, the letter notes.

“As these changes are implemented, it will be essential to ensure that program requirements are aligned across all participants, including physicians, hospitals and critical access hospitals,” wrote the AHA. “…The Oct. 14 final regulations for MACRA fall short in this regard.”