House Committee Releases Comprehensive Bill that Includes Pierluisi Bill to Improve Treatment of Puerto Rico Hospitals

Washington, DC—The Committee on Ways and Means in the U.S. House of Representatives today unveiled a comprehensive bill, the Hospitals Improvements for Payment Act of 2016, that contains the Committee’s priorities related to hospital reform, and the language of H.R. 1379—the bill authored by Resident Commissioner Pedro Pierluisi to enable hospitals in Puerto Rico to receive bonus payments under Medicare for adopting electronic health records—is included within this package.  This is an important step forward, and significantly improves the likelihood that Pierluisi’s bill will be enacted into law when the next Congress convenes in 2015.

H.R. 1379 seeks to correct an oversight in the Health Information Technology for Economic and Clinical Health Act, known as the HITECH Act.  The goal of the HITECH Act is to encourage doctors and hospitals to use electronic health records, which can improve patient care, reduce medical errors, and lower health care costs.

To promote the adoption of electronic health records, the HITECH Act authorizes bonus payments under Medicare and Medicaid for doctors and hospitals that become “meaningful users” of electronic health records.  The Medicare incentive program consists of both “sticks” and “carrots,” meaning that physicians and hospitals will be penalized if they fail to adopt electronic health records by a certain date.

However, the HITECH Act omitted Puerto Rico hospitals from the Medicare incentive program.  This exclusion appears to have been inadvertent, since the bill makes island physicians eligible for the bonus payments under both Medicare and Medicaid, and makes island hospitals eligible for the bonus payments under Medicaid.

It is estimated that including Puerto Rico hospitals in the Medicare portion of the HITECH Act would result in approximately $200 million in additional federal payments to island hospitals over the next decade. 

“There is no principled basis to exclude Puerto Rico hospitals from the Medicare component of the HITECH Act and this exclusion has significantly hampered efforts to adopt electronic health records on the island, to the detriment of both patients and hospitals,” said Pierluisi.

The Resident Commissioner’s legislation—included as Section 210 of the Hospitals Improvements for Payment Act of 2014—would treat Puerto Rico hospitals like hospitals in the states, making them eligible for Medicare bonus payments if they become meaningful users of electronic health records and subjecting them to penalties—in the form of reduced Medicare reimbursement rates—if they fail to do so by a certain date.  H.R. 1379 has been cosponsored by 13 Members of Congress:  eight Democrats and five Republicans.

Senator Robert Menendez of New Jersey introduced an identical companion bill in the U.S. Senate, which is cosponsored by the Republican Senator from Florida, Marco Rubio, and the Democratic Senator from Florida, Bill Nelson.  Pierluisi and Menendez have been working closely together on this legislation for several years.  

“Puerto Rico hospitals are not seeking preferential or special treatment.  They are simply seeking equal treatment.  This bill would ensure they receive the same bonus payments as hospital in the states for adopting electronic health records,” said Pierluisi.

The Resident Commissioner expressed gratitude to the Puerto Rico Hospital Association, which has strongly supported H.R. 1379.  He thanked the Association for raising awareness about the bill among both Democrats and Republicans, noting that the Association played a critical role in the effort to convince leaders of the Ways and Means Committee to include H.R. 1379 in the package unveiled today.

Pierluisi also thanked Senator Menendez for his steadfast support for the people of Puerto Rico and for always looking for ways to improve Puerto Rico’s treatment under federal health programs.