Key Takeaways:
- The House Committee on Energy and Commerce Subcommittee on Health (Subcommittee) has been holding a series of hearings focused on lowering health care costs, with a specific emphasis on insurer practices, hospital pricing and pharmaceutical supply chains.
- The continuation of these hearings discussing efforts to lower health care costs could lead to future litigation and increased enforcement activity.
- The Subcommittee’s next hearing, titled, Lowering Health Care Costs for All Americans: An Examination of the U.S. Provider Landscape, is scheduled to take place on March 18 at 10:15 AM ET.
- The House Committee on Energy and Commerce Subcommittee on Oversight & Investigations will also be hosting a hearing, titled Protecting Patients and Safeguarding Taxpayer Dollars: The Role of CMS Medicare and Medicaid Fraud. This hearing is scheduled to take place on March 17 at 2:00 PM ET.
- The House Committee on Ways and Means will likely also hold a hearing on health care costs in the coming weeks.
The House Committee on Energy and Commerce — Implications of Hearings on Health Care Costs
These hearings will likely require hospitals and industry stakeholders to testify and are expected to bring attention to several key health care issues. One key issue expected to receive particular attention is site-neutral payment policies for outpatient services. Under this model, Medicare reimbursement would be based on the Physician Fee Schedule and paid at the same rate regardless of whether it was furnished in a hospital outpatient setting or a physician’s office.
This issue may require hospitals to testify regarding their cost structures, including overhead and operational expenses associated with hospital-based care. Physicians are likely to be asked about the Medicare Physician Fee Schedule and potential changes that could improve efficiency.
House Committee on Ways and Means Expected Hearings
Similarly, the House Committee on Ways and Means will likely also hold a hearing on health care costs in the coming weeks. These hearings may explore the concerns raised by some policymakers and for-profit hospital representatives that nonprofit hospitals may not be providing sufficient care to indigent or underserved populations, given their tax-exempt status and the potential for positive operating margins.
Looking Ahead
Both Committees may focus on matters left out of the One Big Beautiful Bill Act last year, including Medicare reform, HSA expansion, restrictions on reproductive services, Medicaid penalties and other administrative changes.
As a result, these hearings may lead to increased regulatory scrutiny and enforcement activity, including potential investigations related to Medicare and Medicaid billing practices. In addition, policy changes related to site-neutral payment or nonprofit hospital oversight could result in future litigation challenging reimbursement policies, administrative actions and compliance requirements.
Sylvia Kornegay, Christopher C. Rorick, and Clare Chmiel contributed to this article
