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House Bill Could Help Health Plans Improve Provider Directories

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What You Need to Know

  • Ways and Means members focused on marking up a maternal health bill that was shaped by the late Jackie Walorski, who died Aug. 3 in a car crash.
  • Her husband and mother were in the hearing room, and committee members approved the maternal health bill, and all other health bills considered, by voice votes.
  • Members honored the memory of Walorski by holding a recorded vote on the maternal health bill.

House Ways and Means Committee members honored the memory of the late Rep. Jackie Walorski, R-Ind., Wednesday by uniting to pass bills that could improve Medicare and commercial health coverage.

One of the bills approved, Committee Print 117-4, would require the doctors and other care providers in a health plan’s provider directory to tell the plan, at least once a year, whether they were accepting new patients.

Providers would also have to say whether they were offering new patients in-person appointments, telehealth appointments or both.

Rep. Lloyd Doggett, D-Texas, said requiring providers to send in updates annually could help health plans keep their provider directories current. “I’d like to see it done much more frequently,” he said. “But at least this is progress in the right direction.”

What It Means

If Committee Print 4 becomes law and works as supporters hope, you and your clients might soon have an easier time finding in-network doctors.

Jackie Walorski

Ways and Means members endorsed Committee Print 4, and all of the other bills were considered at a “markup,” or bill consideration meeting, by a voice vote, as Walorski’s husband, Dean Swihart, and mother, Martha Walorski, looked on from seats in the hearing room.

Jackie Walorski died Aug. 3 in a car crash in Indiana at the age of 58.

“We know how much Jackie loved you,” Rep. Richard Neal, D-Mass, the chairman of the committee, told Walorski’s husband and mother at the markup, which was streamed live on the web. “You should know how much we all loved her. She was taken from us too early.”

Neal emphasized that Democrats and Republicans had worked together for two years on the provider directory bill and the other bills being marked up, and that Walorski had taken the lead in negotiations for one of the bills considered, H.R. 8876, the Jackie Walorski Maternal and Child Home Visiting Reauthorization Act of 2022 bill, which would renew and increase grant funding for state programs that send support workers into the homes of pregnant women, babies and small children.

Rep. Kevin Brady, R-Texas, the highest ranking Republican on the committee, said the last conversation he had with Walorski, over Zoom, was about H.R. 8876.

Members started out by agreeing to H.R. 8876 with a voice vote.

“You can clap,” Neal said after the bill passed.

Rep. Brad Wenstrup, R-Ohio, then asked Neal to hold a recorded vote.

“I believe everyone on this committee would like to have their names recorded in association with this bill we have today,” he said.

H.R. 8876 passed a second time through the recorded vote. Members and guests then rose to celebrate the vote, and show their respect for Walorski, with a standing ovation.

Other Legislation Passed

Ways and Means members approved H.R. 8885 as part of a Committee Print 117-4, a package of three bills.

Another bill in that package would require health plans that cover mental health care and substance abuse disorder care to use World Health Organization or American Psychiatric Association definitions when describing their behavioral health benefits.

Part of the Committee Print 117-5 package would require federal agencies to develop a system for rating the size of a health plan’s mental health care and substance abuse disorder care provider list.

A second Committee Print 117-5 package section could help health insurance web brokers and health plan comparison app makers, by requiring health plans to post all “summary of benefits and coverage” notices, in machine-readable language, on the web.

The provision could help insurance technology companies and other companies pull in and analyze health plan SBC data. SBC-based tools could help users give consumers better information about health plan benefits, analyze health plan benefits trends, and identify common gaps in health plan coverage.

Committee Print-2 would add an intensive outpatient services coverage category to Medicare for people with mental health or substance abuse problems that are not quite severe enough to justify use of inpatient care but are too challenging to be handled with fewer than 20 hours of care per week.

The Process

Doggett said during the hearing that Ways and Means members received the legislation text Monday and the names of the legislation sponsors on Tuesday.

He criticized members’ lack of time to consider the bills.

“More could have been achieved with greater, involvement and notice,” he said.

Pictured: House Ways and Means Chair Richard Neal, a Democrat, looks on as Rep. Kevin Brady, a Republican, talks about H.R. 8876, the Jackie Walorski Maternal and Child Home Visiting Reauthorization Act of 2022 bill.


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