Legislation introduced to reduce health care costs contains funding resources for local health departments

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U.S. Senate HELP Committee releases bipartisan draft legislative package aimed at reducing patient medical costs & improving bill transparency The sweeping legislation also includes measures to boost state & local public health programming Congress’ introduction of bipartisan cost containment legislation follows months of consideration in health committees

On May 23, the U.S. Senate Health, Education, Labor and Pensions (HELP) Committee released a bipartisan draft legislative package, the Lower Health Care Costs Act (bill not yet numbered), that would end surprise medical billing for patients, promote billing transparency and reduce prescription drug prices. The sweeping drug-pricing and health legislation, which represents a major focus for House and Senate legislators in the 116th Congress, contains five titles ranging from improving health information technology and committing new federal funding to state and local public health efforts.

The bill’s focus on cost containment and its grant resources for state and local public health programming help fulfill counties’ goal of health care access and affordability for residents. Title I of the bill addresses medical costs and attempts to end surprise medical billing, which can occur when a patient is treated by an out-of-network provider, regardless of the patient’s knowledge of the provider’s network status. The Senate’s legislation would require health care providers to give patients advance notice of any out-of-network care, as well as an estimate of the patient’s costs and referrals for in-network care options. Patients not receiving adequate notice would be insulated from surprise bills or liability for out-of-network cost-sharing.

In addition to these patient protections, Title II of the legislation introduces new transparency requirements for health care plans and providers. Health care plans, for instance, would be required to maintain up-to-date directories of their in-network providers. Meanwhile, health care providers would be required to give patients a list of services received and to send medical bills to patients within 30 business days.

Legislative package would commit new resources to state and local public health providers

Within the broader legislative package and of special importance to counties, Titles IV and V of the bill would direct new resources to state and local health departments. The chart below provides further detail on the provisions that could directly assist counties as health providers.

Measures contained in Title IV, for instance, would support state and local efforts to harness health information technology to meet patient needs in medically underserved areas (Sec. 404) and improve health data collection (Sec. 405) – two long-standing NACo health policy priorities. Title V, meanwhile, focuses on improving the exchange of health information, especially as it relates to patient data protection under the Health Insurance Portability and Accountability Act (HIPAA) rules. NACo supports streamlining HIPAA privacy provisions to allow for greater information-sharing across health care providers.

Lower Health Care Costs Act Title IV Measures Important to Counties



Section 402: Grants to Address Vaccine-Preventable Diseases

• Authorizes grants for planning and implementation of activities to address vaccine-preventable diseases and for research on improving awareness of evidence-based vaccine-related information

Section 403: Guide on Evidence-Based Strategies for State Health Department Obesity Prevention Programs

• Requires HHS to develop and disseminate a guide on evidence-based obesity prevention and control strategies for state, local and tribal health departments

Section 404: Expanding Capacity for Health Outcomes

• Authorizes grants to evaluate, develop and expand the use of technology-enabled collaborative learning and capacity-building models to increase access to specialty health care services for medically underserved areas and populations

Section 405: Public Health Data System Modernization

• Requires HHS to award grants to state and local public health departments to improve data collection capabilities, simplify data-reporting by health care providers, enhance interoperability of public health data systems with health information technology and support earlier disease detection and electronic case reporting

• Authorizes the CDC to update and improve public health data systems

Section 406: Innovation for Maternal Health

• Directs HHS to establish a grant program for the purpose of improving maternal health care  and eliminating preventable maternal mortality and severe maternal mortality by identifying, developing and disseminating best practices to improve maternal health outcomes

Section 407: Training for Health Care Providers

• Establishes an HHS grant program for the training of health care professionals to reduce and prevent discrimination, including training related to implicit biases, in the provision of health care services related to prenatal care, labor care, birthing and post-partum care

Lower Health Care Costs Act Title V Measures Important to Counties



Section 502: Recognition of security practices

• Incentivizes health care entities to adopt strong cybersecurity practices by encouraging the HHS Secretary to consider entities’ adoption of recognized cybersecurity practices when reviewing or administering fines related to Health Insurance Portability and Accountability Act (HIPAA) laws

Section 503: Study on privacy and security risks of electronic transmission of health information not covered under HIPAA

• Requests a Government Accountability Office study to better understand gaps in privacy protections for health information as patients move their information to third parties that are not covered by Health Insurance Portability and Accountability Act (HIPAA) rules

Next steps on the legislation

Senate HELP Committee leadership is currently considering stakeholder comments on the Lower Health Care Costs Act, and sponsors have indicated that the bill could be considered on the Senate floor in early July. NACo is engaging with key congressional offices on this legislation to ensure local public health departments have the resources necessary to deliver high-quality and affordable health care to our residents.
At NACo’s 2019 Annual Conference this July, the Health Steering Committee will focus on Congress’ efforts around prescription drug pricing and how legislation currently under consideration could impact counties as health providers for our residents. Click here for more information on this session and to view the full conference schedule.

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