HIP Act

Healthy Inpatient Procedures Act of 2016 or the HIP Act

This bill delays and suspends implementation of Medicare's Comprehensive Care for Joint Replacement Model, which tests episode-based payment and quality measurement for care associated with hip and knee replacements.

The bill also reduces and rescinds specified FY2017 and FY2018 funding that was appropriated for the Prevention and Public Health Trust Fund.

[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4848 Introduced in House (IH)]

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114th CONGRESS
  2d Session
                                H. R. 4848

 To delay and suspend implementation of a comprehensive care for joint 
  replacement (CJR) payment model for episode-based payment for lower 
  extremity joint replacement (LEJR) under the Medicare program in a 
                         budget neutral manner.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 23, 2016

 Mr. Tom Price of Georgia (for himself and Mr. David Scott of Georgia) 
 introduced the following bill; which was referred to the Committee on 
   Energy and Commerce, and in addition to the Committee on Ways and 
 Means, for a period to be subsequently determined by the Speaker, in 
   each case for consideration of such provisions as fall within the 
                jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
 To delay and suspend implementation of a comprehensive care for joint 
  replacement (CJR) payment model for episode-based payment for lower 
  extremity joint replacement (LEJR) under the Medicare program in a 
                         budget neutral manner.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Healthy Inpatient Procedures Act of 
2016'' or the ``HIP Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Patient choice has a uniquely positive influence in 
        achieving quality, responsiveness, effectiveness, and 
        efficiency of health care services.
            (2) The implementation of a Medicare payment model for 
        comprehensive care for joint replacement (CJR) represents a 
        significant change to the health care delivery system which 
        could have a negative impact on patient choice, access, and 
        quality.
            (3) Patients with higher-cost complex surgeries (such as 
        hip fractures and ankle replacement procedures) or who suffer 
        from multiple chronic conditions may especially be at risk in 
        the implementation of that model.
            (4) The implementation of that model beginning April 1, 
        2016, provides physicians, hospitals, and post-acute providers 
        with inadequate time to prepare for this abrupt shift in 
        payment for these high-volume procedures and the changes in 
        care delivery that they require.

SEC. 3. DELAY AND SUSPENSION OF IMPLEMENTATION OF A COMPREHENSIVE CARE 
              FOR JOINT REPLACEMENT (CJR) MEDICARE PAYMENT MODEL FOR 
              LOWER EXTREMITY JOINT REPLACEMENT (LEJR) IN A BUDGET 
              NEUTRAL MANNER.

    (a) In General.--The Secretary of Health and Human Services shall 
not implement (and shall suspend any further implementation of) before 
January 1, 2018, the testing of a Comprehensive Care for Joint 
Replacement Model (CJR) (described in the rule published in the Federal 
Register on November 24, 2015 (80 Fed. Reg. 73274-73554)) to be 
conducted under section 1115A of the Social Security Act (42 U.S.C. 
1315a) as an episode-based payment model for lower extremity joint 
replacement (LEJR). This section shall not apply to implementation of 
such model that has occurred before the date of the enactment of this 
Act.
    (b) Construction.--Nothing in this section shall be construed to 
affect the authority of the Secretary to require the participation of 
providers of services, suppliers, and beneficiaries in the testing or 
expansion of any other innovative payment and service delivery model 
under section 1115A of the Social Security Act (42 U.S.C. 1315a).
    (c) Offsetting Additional Expenditures Through Reductions in 
Amounts Appropriated to the Prevention and Public Health Trust Fund.--
Notwithstanding any other provision of law, the amount otherwise 
appropriated to the Prevention and Public Health Trust Fund under 
section 4002(b) of the Public Health Service Act (42 U.S.C. 300u-
11(b))--
            (1) for fiscal year 2017 is reduced (and rescinded) by 
        $180,000,000 (or $185,000,000 if this Act is enacted before 
        July 1, 2016); and
            (2) for fiscal year 2018 is reduced (and rescinded) by 
        $50,000,000.
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