publishes OCC Advisory Circular (AC) 120-96A  

House Energy & Commerce Medicaid Task Force: Overview


FAA publishes OCC Advisory Circular (AC) 120-96A  

This week, the FAA published Advisory Circular (AC) 120-96A:  Operations Control Centers (OCC) for Helicopter Air Ambulance (HAA) Operations.  This AC provides guidance information and recommendations to assist operators in developing OCCs and integrating OCC procedures into their operations.  As you are probably aware, operators with 10 or more aircraft are now required to develop an OCC, while smaller operators are encouraged to do so.  AAMS will be working with its membership to review the AC and providing the appropriate feedback to the FAA.

The AC can be viewed here.

House Energy & Commerce Medicaid Task Force: Overview

On November 5, 2015, House Energy & Commerce Committee Chairman Fred Upton (R-MI) announced the creation of a new Medicaid task force – chaired by Rep. Brett Guthrie (R-KY) – to examine ways to ensure the strength and sustainability of the program. In a recent Op-Ed piece in the Lexington Herald-Ledger, Rep. Guthrie, chair of the task force, discussed the purpose of the task force and gave some insight into how the body will operate and its goals. Guthrie notes that the purpose of the task force is to help members of Congress better understand the role Medicaid plays in the American health care system and broaden their expertise in the Medicaid program.

Medicaid has grown significantly in recent years with 22.9 percent of Americans — 73 million people — covered by Medicaid programs. Notably, 48% of House Republicans represent districts in States that have expanded Medicaid under the ACA. This boom in Medicaid enrollment post-ACA has led to questions by Republicans regarding the trajectory of the Medicaid program – in terms of spending, enrollment and benefit structure. In 2015, the committee held a number of hearings on Medicaid, including one reviewing the accuracy of Medicaid and exchange eligibility determinations. The committee also looked at Medicaid fraud and improper payments, questioning CMS on why the agency increased the program’s target improper payment rate in both hearings and letters to the agency.

Task Force Membership
The task force is comprised of eight Republican lawmakers from a mix of Medicaid expansion and non-Medicaid expansion states including:

  • Rep. Brett Guthrie (R-KY) – Chair
  • Rep. Michael C. Burgess, M.D. (R-TX)
  • Rep. Marsha Blackburn (R-TN)
  • Rep. Chris Collins (R-NY)
  • Rep. Susan Brooks (R-IN)
  • Rep. Bill Flores (R-TX)
  • Rep. Larry Bucshon (R-IN)
  • Rep. Markwayne Mullin (R-OK)

Legislative Markers to Watch:  While the Task Force has not yet announced or endorsed specific legislative proposals, the Energy & Commerce Subcommittee on Health has considered several Medicaid proposals over the course of the past few months which might provide some indication of the proposals under consideration. Recently, the Subcommittee approved several Medicaid-related bills, including:

H.R. 3716 – The Ensuring Terminated Providers are Removed from Medicaid and CHIP Act, Rep. Larry Buchson, M.D. (R-IN)

This bill addresses issues raised in a recent report from the Health and Human Services Office of the Inspector General that found health care providers terminated from Medicaid in one state were still participating in Medicaid and CHIP programs in other states.

H.R. 1570 – The Medicaid and CHIP Territory Transparency Act, Rep. Gus Bilirakis (R-FL).

H.R. 1570 requires CMS to include similar information on the Medicaid and CHIP Programs in the territories on its website as it provides to the states.

H.R. 1771 – No official title, Rep. Markwayne Mullin (R-OK)

This measure would close a loophole identified by GAO by counting portions of income from
annuities of a community spouse as income available to institutionalized spouses for purposes of determining Medicaid eligibility for long-term care services.

H.R. 2339 – No official title, Subcommittee Chairman Joe Pitts (R-PA)

This measure would give states better options as to how lottery winnings are calculated for purposes of Medicaid eligibility.

H.R. 2446 – The Electronic Visit Verification System Required for Personal Care Services Under Medicaid, Subcommittee Vice Chairman Brett Guthrie (R-KY)

This bill requires states to have in place an electronic visit verification system for personal care services.

H.R. 3444 – The Medicaid and CHIP Territory Fraud Prevention Act, Subcommittee Chairman Joe Pitts (R-PA) and Rep. Susan Brooks (R-IN)

This bill would encourage territories to create Medicaid Fraud Control Units.

Workplan:  Many stakeholders have expressed concern that the Republican-led Task Force intends to produce policy recommendations that would dramatically reduce federal Medicaid spending, restrict waiver authority, and restructure the program into block grants. Given the Energy and Commerce has sole jurisdiction over the Medicaid program in the House, the Task Force provides an opportunity to be thoughtful and deliberative about any potential reforms that might take place in 2017 under a Republican administration. Members and staff hope to build a baseline of knowledge about the intricacies of the Medicaid program over the coming months.

Meetings: Members of the Task Force are meeting monthly (next the week of 1/25) with weekly staff meetings in between.

Outreach: Sometime early second quarter (March/April) the Task Force anticipates engaging in additional outreach with states, providers, beneficiary groups, plans, researchers, and other stakeholders who have ideas and solutions to improve access and outcomes for Medicaid beneficiaries.

Policy Development: As dialogue advances, the Task Force will work to formulate policy ideas consistent with the broader agenda around entitlements in 2017. The trajectory of these policy recommendations will be impacted to some extent by the outcome of the Presidential election as well as the leadership of the full Committee.