Congressional Status:
House: In Session
Senate: In Session
A Service From AAOE Government Affairs Specialist Bradley Coffey, MA
Volume II, Issue XVIII
Senate Holds Interoperability Hearings
Inside this issue:
J un e 1 0, 201 5
President Challenges Congress in King Case
2
Americans Want Health IT
2
Supreme Court Hears Medi- 2
caid Case
Trade Promotion Authority
a Hot Topic
3
Democrats Win Congressional Baseball Game
4
States Try to Stop Surprise
Medical Billing
5
Florida BONES Triumphs in
Tallahassee
6
Special points of interest:
The Senate Health, Education,
Labor, and Pensions (HELP)
Committee held a hearing on
interoperability today. Chaired
by Senator Lamar Alexander
(R-TN), the committee has held
several hearings this year to
discuss what legislative remedies are available to Congress.
During the hearing, Senator
Alexander asked witnesses if
they believed that Stage III of
the Meaningful Use program
should be delayed. Tom Payne,
the board chair-elect of the
American Medical Informatics
Association, answered that the
Stage should be delayed “until
it’s [interoperability] fixed.” A
representative from a patient
advocate group cautioned,
however, that a “delay should
be considered with what we
would give up.” She was talking about Stage III’s requirement to increase patient engagement through the downloading and transmission of
their records, a position that
patient advocacy groups have
been loudly supporting.
Also testifying at the hearing
was Cerner CEO Neal Patterson who touted the efforts of
the CommonWell Health Alliance. The mention of CommonWell brought Senator Bill
Cassidy (R-LA) to mention
The Senate HELP Committee.
Epic who is not a member of
CommonWell and was subject
to a brutal congressional hearing last year.
The Senate HELP Committee
will hold another hearing on
interoperability next week.
H o u s e C o m m i t t e e S c h e d u l e s Ap pr o p s. M a r k U p
J un e 1 2, 201 5
 Healthcare News!
 Capitol Hill News!
 Executive Branch News!
 Judiciary News!
 Budget News!
 Capitol Hill Gossip!
The Labor, Health and Human
Services, and Education Subcommittee of the House Appropriations Committee has scheduled a mark up session of the
FY2016 Labor, HHS, and Education appropriations bill. Clerk
of the Committee, William
Smith, announced the hearing,
scheduled for June 17 at 9:00
am ET, today.
A mark up is the first step of
subcommittee or committee
consideration where the members will discuss any issues that
they have with the legislation
and offer amendments to the
bill. Once the legislation is
“marked up” it is reported from
the subcommittee to the committee which will then mark up
the legislation again. The committee will then report the legislation and it will be placed on
one of the House Calendars.
Page 2
Coffey Talk From the Hill
P r e s i d e n t C h a l l e n ge s C o n g r e s s i n King C a s e
J un e 9 , 2 015
The Supreme Court is expected
to rule before the end of June in
King v. Burwell (2015) on
whether the Internal Revenue
Service (IRS) may extend federal subsidies to the millions of
Americans who have purchased
their health insurance on the
federal healthcare exchange.
Residents in 34 states are currently receiving subsidies for
purchasing their health insurance on the federal exchange.
This week, the President has
tried to use the bully pulpit of
the presidency to place the
blame for a potential adverse
ruling on Congressional Republicans, many of whom have
made it their job to try and repeal the law. “We’re not going
to go backwards,” the President
told a Catholic hospital association today. “Let’s figure out
how to make it better. It seems
so cynical to want to take coverage away from millions of
people.”
A ruling against the administration would likely mean the end
of the Affordable Care Act’s
individual mandate which in
turn would make coverage of
pre-existing conditions too ex-
pensive for insurance which
would defeat the purpose of the
legislation: to expand health
coverage.
Senate Majority Leader Mitch
McConnell for his part is keeping mum on Republican plans
in the event that the Supreme
Court overturns the practice but
many expect the Republican
party to be torn between moderates who want to see a temporary fix and Tea Party conservatives who want immediate repeal.
Am e r i c a n s Wa n t H e a l t h I T
J un e 1 2, 201 5
The report indicates that
Americans want to
access their medical
records online.
54.9 percent of Americans have
told researchers that it is important for them to have electronic access to their medical
records, a 10.6 point increase
from a 2008 survey. These findings were published today in a
report from the Agency for
Healthcare Research and Quality (AHRQ), an agency of the
Department of Health and Human Services (HHS).
53.1 percent of Americans indi-
cated that it was important that
their healthcare provider be
able to share medical information electronically with other
providers, a practice known as
interoperability. This increased
12.4 points since the 2008
study.
Numbers like this indicate that
Congress and the Centers for
Medicare and Medicaid Services have less of an incentive
to relax legislation and regula-
tions requiring providers to
allow patient access to their
healthcare records, and even
less of an incentive to relax
attempts at interoperability.
The report also noted that hospital exchange of patient medication history increased from
13.4 percent to 30.7 percent
across all regions of the United
States.
Adva n c e d C a r e P l a n n i n g B i l l I n t r o d u c e d i n S e n a t e
J un e 1 0, 201 5
Georgia Senator Johnny
Isakson (R).
Senators Mark Warner (D-VA)
and Johnny Isakson (R-GA)
have introduced legislation that
would authorize Medicare to
pay physicians and other
healthcare providers who have
voluntary discussions about end
-of-life care with patients diagnosed with a serious or lifethreatening illness. The legisla-
tion calls to mind a provision of
the Affordable Care Act (ACA)
which opponents argued would
lead to “death panels”.
Isakson’s involvement with the
legislation is notable because
just this week the Senator announced that he was in the
early stages of Parkinson’s Disease. Warner often speaks to
groups about his mother’s
drawn out battle with Alzheimer’s and the family’s failure to
discuss her wishes while she
was capable of telling them.
Neither this legislation, nor its
companion bill in the House of
Representatives have progressed past the committee
stage.
Volume II, Issue XVIII
Page 3
Tr a d e P r o m o t i o n Au t h o r i t y a H o t To pi c
J un e 1 2, 201 5
Republicans in the House and
Senate are seeking to give President Obama more power to
negotiate trade deals and the
legislation has pitted the President against congressional
Democrats. At a closed door
meeting with House Democrats, Representative Rosa DeLauro (D-CT) offered a blunt
message: vote to cut Medicare
(cuts to Medicare are included
in the bill to fund a job training
program critical to the getting
organized labor behind the bill),
and members could soon find
themselves out of a job.
of 1985.
House Minority Leader Nancy
Pelosi and Speaker of the
House John Boehner have been
working to avoid cuts to Medicare but Pelosi has shut down
those talks. Legislation was
passed by the House and later
amended by the Senate with the
cuts to Medicare included
among the amendments. The
amendment would cut Medicare by 0.25 percent in 2024 as
part of the sequestration cuts to
Medicare in the Balanced Budget
and Emergency Deficit Control Act
In order to get the legislation
passed and to the President’s
desk, House leaders crafted a
rule requiring that three votes
would be held, one the trade
adjustment assistance (TAA)
with the Medicare cuts, the
TAA without the cuts, and a
vote on trade promotion authority (TPA). Once the vote on
the TAA without the cuts passes, the rule states that the cuts
would be considered passed as
well and the legislation would
go to President Obama’s desk.
Passage of the trade promotion
authority is dependent upon
passage of the trade adjustment.
If the House refused to concur
in the TAA amendment, TPA
would go to a conference committee where the Senate and
House would work out their
differences. This rule allows
Democrats who do not want to
vote to cut Medicare the option
of voting against the rule while
voting for the cut-free TAA.
Look for more information on
the outcomes of this battle in
next week’s issue.
N ew N e t N e u t r a l i t y Ru l e s g o I n t o Ef f e c t
J un e 1 1, 201 5
The Federal Communications
Commission (FCC) scored a
victory in the US Court of Appeals for the District of Columbia today when the court denied a request for a stay brought
by opponents of net neutrality.
“Petitioners have not satisfied
the stringent requirements for a
stay pending court review.” The
three judge panel wrote thereby
allowing new rules on net neu-
trality to take effect on June 12
at 12:01 am.
The new rules classify internet
service providers as utility companies thereby giving the FCC
greater power to regulate them.
This includes stopping providers from selectively slowing the
speed of online data.
The “doctrine” of net neutrality
requires that all internet traffic
be treated equally. Under net
neutrality, internet service providers like Xfinity/Comcast,
Time Warner, ATT, etc. may
not charge a website more to
allow faster data speeds. Webbased entertainment companies
like Netflix have been fighting
for net neutrality since the doctrine was first invalidated by the
same court in 2014 due to a
different FCC classification.
Net neutrality requires
internet service providers
to treat all internet traffic
equally.
L i b r a r i a n o f C o n g r e s s Re t i r e s
J un e 1 0, 201 5
Librarian of Congress James
Billington announced that he
will retire from the position
today. His retirement will be
effective January 1, 2016.
Billington was nominated to the
position by President Ronald
Reagan and is the 13th librarian
of Congress. Serving since
1987, he has presided over one
of the greatest changes to print
media since the invention of the
Gutenberg Press, the digitization of the Library of Congress.
Under Billington’s direction,
the Library of Congress digitized the activities of Congress
with THOMAS which eventually became congress.gov. Billington’s tenure also saw the
library double its collection to
more than 120 million items.
House and Senate leaders were
bipartisan in their praise for
Billington’s tenure wishing the
86 year-old a long and happy
retirement. Billington was previously the director of the
Woodrow Wilson International
Center for Scholars.
Dr. James Billington will
retire from his position as
Librarian of Congress,
effective January 1, 2016.
Page 4
Coffey Talk From the Hill
D e m o c r a t s Wi n C o n g r e s s i o n a l B a s e b a l l G a m e
J un e 1 1, 201 5
Speaker of the House John Boehner (ROH) at the 2012 Congressional Baseball
Game at Nationals Park.
Congressional Democrats have
won their seventh straight victory in the 54th Annual Roll Call
Congressional Baseball Game
triumphing over Congressional
Republicans 5-2. Democrats
lead the series now 39-38-1.
for fast track trade authority.
Indeed, while Democratic staffers were cheering for the President, Republican staffers broke
out in chants of “TPA! TPA!”,
a reference to trade promotion
authority.
The game is played to benefit
charities in the Washington,
DC area and frequently draws
congressional staff to cheer on
their “home team” but this
year, President Barack Obama
stopped by the game and met
with the players, presumably
with a desire to secure support
“Listen, I love the President.
And I’m always happy when he
comes. But it was kind of like a
circus for a while with him out
here,” Democratic manager
Mike Doyle (D-PA) told Roll
Call with a chuckle. “No, it was
great to see him come. A presi-
dent shows up to see your ball
game, that’s pretty good stuff.”
Doyle noted that the game was
closer than usual (Republicans
lost last year 15-6) and pointed
to the GOP’s new pitcher,
freshman Mark Walker (R-NC)
who apparently throws a mean
curve ball. Rep. Marlin Stutzman (R-IN) assured his teammates that they’d bring the trophy back to the GOP caucus
next year adding, “I’m a Cubs
fan so…”
W h i t e H o u s e a n d C a pi t o l Eva c u a t e d
J un e 9 , 2 015
Press was evacuated from
the West Wing after a
caller informed police
that there was a bomb in
the West Wing.
The James S. Brady Briefing
room at the White House and
the Dirksen Senate Building
were evacuated today after a
pair of bomb threats were made
against the buildings. Dirksen
was the first to be evacuated
after someone called US Capitol Police and stated that a
bomb had been placed in the
third floor offices of the Senate
Homeland Security Committee.
The Committee was set to hear
testimony on TSA failures to
detect, ironically, bombs in
luggage.
The White House Briefing
Room was evacuated while
White House Press Secretary
Josh Earnest was hosting his
daily press briefing. The President was in the Oval Office at
the time and was not evacuated
according to Earnest. The rest
of the First Family was in the
residence and also was not
evacuated. It is unclear why
only part of the West Wing was
evacuated.
Authorities are still uncertain
whether both evacuations were
related or coincidence.
Wa n t F l o o r U p d a t e s ? G o t o t h e A pp S t o r e !
J un e 1 1, 201 5
House Democratic Whip Steny
Hoyer (MD) released “Whip
Watch” today on the Apple
App Store. The app gives iOS
users a look into the House of
Representatives and the House
Democratic Caucus.
The office of the Democratic Whip released
“Whip Watch” today.
“By downloading this app, any
American interested in the dayto-day workings of the House
Floor can receive the latest
updates and news in real time,”
Hoyer stated. “It is an important step in my efforts to
make this institution more open
and transparent, and I encourage Members, staff, the press,
and public to download the
new app today.”
the House Democratic Caucus
with whip messages attached to
legislative descriptions such as
the one attached to a description of today’s rule to consider
a Senate amended trade promotion authority bill which stated
“members are urged to VOTE
NO.”
The updates give a glimpse into
Android version coming soon!
Page 5
Coffey Talk From the Hill
State Legislatures in Session:
Alaska, California, Delaware, District of
Columbia, Florida, Illinois, Kansas,
Louisiana, Maine, Massachusetts,
Michigan, Nebraska, New Hampshire,
New Jersey, New Mexico, New York,
North Carolina, North Dakota, Ohio,
Oregon, Pennsylvania, Rhode Island,
South Carolina, Wisconsin
S t a t e s Tr y t o S t o p S u r p r i s e M e d i c a l B i l l i n g
J un e 1 1, 201 5
States are attempting to crack down on
balance billing practices.
Politico is reporting that states
have been working to stop an
unintended consequence of the
Affordable Care Act (ACA),
patients receiving surprise bills
in the mail. California, Florida,
Texas, New Jersey, and New
York are just four of the states
that have recently sought to end
or curtail the practice of
“balance billing”.
The newspaper blames the issue
on the proliferation of cheaper
insurance plans on the ACA
exchanges which provide narrower networks to keep costs
down. According to the paper,
this increases the likelihood that
patients will end up receiving
care from an out-of-network
provider.
In Texas, the three largest insurers had widespread use of
out-of-network providers at innetwork facilities (emergency),
according to a 2014 study from
the Center for Public Policy
Priorities. Texas had previously
had a mechanism for patients to
challenge surprise bill but the
threshold was $1,000. The legislature lowered that threshold to
$500 in the 2015 legislative
session.
A law took effect in April in
New York that prohibits providers from charging higher fees
for emergency care if some
caregivers are out of network
while California is considering
a similar bill. The California
Assembly passed the legislation
in early June but the Senate has
yet to take up the bill.
Similar legislation has been
introduced in New Jersey but
its success looks unlikely.
F u t u r e D o c t o r s t o b e Tr a i n e d i n LG B T H e a l t h
J un e 1 1, 201 5
The University of Louisville will
run the nation’s first pilot program for a new standardized
curriculum on LGBT health.
The University of Louisville
(Go Cards!) School of Medicine
will be the pilot site for a new
curriculum created by the Association of American Medical
Colleges that will train future
physicians on the unique
healthcare concerns of people
who are lesbian, gay, bisexual,
transgender, and gender nonconforming.
"This is a topic that has been
taboo for a long time. Physicians want to provide the best
care for these patients, but they
may not be aware of issues and
how to address someone in a
culturally responsive manner,"
said Faye Jones from the University’s Office of Diversity and
Inclusion. Schools across the
country have been working on
their own programs to help
students understand the unique
aspects of LGBT health but this
is the first attempt at a nationwide, standardized curriculum.
The AAMC noted that Louisville is a great city for the program to begin because of the
city’s diverse population that
mirrors larger cities.
Page 6
F l o r i d a B O N E S Tr i u m ph s i n Ta l l a h a s s e e
J un e 1 2, 201 5
The Florida state legislature in Tallahassee.
Florida BONES and the Florida Orthopaedic Society have
been successful in getting legislation through the House of
Representatives that would
allow Florida ambulatory surgery centers to provide 23 hour
stays for same-day surgical
procedures. AAOE member
and Advocacy Council Chair
Paul Bruning, DHA, ATC was
instrumental to the success of
this legislation in the House,
testifying before several House
committees while the bill made
its way through the legislative
process.
The legislation will now move
on to the Florida Senate. The
Florida Orthopaedic Society
anticipates a vote on the legislation in the Senate Health Policy
Committee on June 16. After
that hearing the legislation will
be sent to another committee
for a second reading and then
finally to the Senate floor.
BSOF and FOS have been
working on this legislation for
the past two years with little
action being taken in the previ-
ous years. The Florida Hospital Association has historically opposed the legislation and
voiced opposition this year.
Passage in the Senate is not
guaranteed.
There are more than 400
ASCs in Florida performing
around 1.5 million surgical
procedures each year. If this
legislation were to become
law, ASCs could perform
more complex procedures—
including spine and other
orthopaedic procedures.
H a c k e r s C o m p r o m i s e I N H e a l t h Re c o r d s
J un e 1 0, 201 5
Medical Informatics
Engineering announced
that it was the victim of a
hack beginning in May
and lasting for 19 days.
A medical software company in
Fort Wayne, IN announced
that it’s systems were hacked on
May 7 and was not detected
until May 26, according to the
Associated Press. Medical Informatics Engineering would not
divulge how many patients
were affected by the hack but
one of its clients includes Texas
based Concentra which operates more than 300 medical
centers in 38 states.
The company alerted the FBI to
the breach and is in the process
of notifying affected medical
groups and patients.
The company creates webbased software for healthcare
providers for electronic health
records and personal healthcare
records.
Ver m o n t G ove r n o r Wo n’t Ru n Ag a i n
J un e 8 , 2 015
Vermont Governor Peter Shumlin.
Vermont’s three-term governor
Peter Shumlin has announced
that he will not seek re-election
in 2016. “I decided to make this
decision now because I want
these 18 months in office” to be
dedicated to policy the Governor said at a news conference
announcing his decision.
Shumlin, a Democrat, was
elected to his first two-year term
in 2010 and has spent the last
few months battling the Vermont Senate for a single-payer
healthcare system. In his announcement, Shumlin noted
that with 18 months left to go,
there is still plenty of time to try
© The American Association of Orthopaedic Executives.
Reproduction and distribution prohibited.
and pass single-payer insurance in Vermont.
Representative Peter Welch,
state Senator Shap Smith, and
former state Senator Matt
Dunne have been named by
Democratic operatives in Vermont.