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Thune-Driven Provisions Included in Medicare Payment Modernization Bill

Thune amendments to Senate Finance Committee’s 2013 markup catalyst for several key Medicare improvements in SGR Repeal Bill

April 14, 2015 - April 15, 2015

Washington, D.C. — 

U.S. Sen. John Thune (R-S.D.) today applauded the Senate’s bipartisan passage of the Medicare Access and Children’s Health Insurance Program Reauthorization Act, H.R. 2, which repeals Medicare’s Sustainable Growth Rate (SGR) formula and modernizes Medicare payments to incentivize high-quality, low-cost care for seniors across the country. This bill also includes a number of provisions to improve quality and value for Medicare beneficiaries that are modeled on amendments Thune offered during the December 2013 markup of the SGR and Medicare Beneficiary Access Improvement Act in the Senate Finance Committee, which served as the base text for H.R. 2.

“For far too long, Congress has kicked the can down the road, patching Medicare physician payments from year to year while failing to modernize the system to provide greater certainty for Medicare patients and physicians,” said Thune. “Rapid growth and changes in health care clearly indicate the need for reform, which is why I’m pleased the Senate acted today to improve quality and value for Medicare patients, while making important improvements for rural health care providers and beneficiaries. These provisions will not only help to strengthen Medicare for future beneficiaries, but will also ensure that rural health care providers have access to the tools needed to provide the highest quality care. I am also pleased several provisions I championed are included in the bill, which will help improve the Medicare program for rural providers and beneficiaries.”

The following provisions either mirror amendment language offered by Thune during the Senate Finance Committee’s 2013 markup the SGR and Medicare Beneficiary Access Improvement Act or closely resemble provisions offered and spearheaded by Thune:

  • Telemedicine Use: This bill includes a Thune provision stipulating that nothing should prevent Medicare from paying for telemedicine services in alternative payment models, which are payment models designed to reward physicians for providing care motivated by quality instead of volume. Currently, telehealth services in Medicare are restricted to use in rural areas and only for certain codes. This bill would ensure that these restrictions are not in place for new alternative payment models created by this bill. 
  • Remote Patient Monitoring: The bill includes a provision requiring the Government Accountability Office (GAO) to study remote patient monitoring and its benefits and barriers and provide a report within two years of enactment. Thune offered an amendment during committee consideration that would create a demonstration program for remote patient monitoring within Medicare. This GAO report will further inform how to create an effective remote patient monitoring program within Medicare to help keep seniors in their homes longer and out of higher acuity, more expensive care settings.  
  • Expansion of Medicare Claims Data Sharing: This bill would also expand the use of Medicare data under CMS’ Qualified Entity program, which would allow organizations to analyze Medicare data and redistribute it for a fee to authorized users such as health plans and providers, so they can make informed decisions about quality. Thune also offered this amendment during the Finance Committee’s consideration of this bill in 2013 based on the Quality Data, Quality Healthcare Act, legislation authored in conjunction with Sen. Tammy Baldwin (D-Wisc.). 
  • Technical Assistance to Rural Health Care Providers.  This bill will ensure that rural health care providers are given sufficient technical assistance to ensure they are able to effectively transition into new payment models.  During committee consideration, Thune offered an amendment to target technical assistance funds to rural areas that may be more likely to encounter difficulty transitioning into alternative payment models. 


  • DME Competitive Bidding. This bill would also correct problems that plague the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive acquisition program and may result in reduced access to necessary medical equipment like oxygen equipment and mobility equipment. This bill includes a provision to require bid surety bonds and state licensure for entities submitting bids under the Medicare DMEPOS competitive acquisition program. Suppliers whose bids are at or below the median price but do not accept a contract forfeit their surety bond. Thune cosponsored a related amendment requiring bidders to be licensed and accredited to provide products or services in the state or geographic area for which they submit and win a bid offered by Sen. Pat Roberts (R-Kan.) during Senate Finance Committee consideration.
  • Health Information Technology (IT) Interoperability: The bill would require the HHS secretary to set the measures of widespread interoperability by July 2018. Thune offered an amendment to require health IT interoperability by 2017 during the Senate Finance Committee’s 2013 consideration of this bill.