House could remove provision from mental health parity bill banning some referrals to specialty hospitals

House leaders said they will change plans to move stand-alone mental health parity legislation after Senate Republicans opposed a provision of the bill that would offset costs by banning physician referrals to specialty hospitals in which the doctors have an ownership interest, CQ Today reports.

The House may delay consideration of the bill until at least Tuesday (Armstrong, CQ Today, 9/19). House leaders on Thursday told mental health lobbyists that the legislation will be taken up as a stand-alone bill this week under suspension of the rules, a procedure that prohibits amendments and requires a two-thirds majority for the bill to pass. The $3.4 billion House measure was expected to be offset by taxes and restrictions on referrals to physician-owned hospitals, according to lobbyists.

Lawmakers in July reached an agreement to combine the House and Senate mental health parity bills by removing a House mandate on coverage of specific mental health conditions in favor of one that would require that mental health benefits be equal to physical health benefits. No funding mechanism was included in the agreement (Kaiser Daily Health Policy Report, 9/19).

According to CongressDaily, House and Senate staffers are "wrangling" over the specialty hospital offset, which is "considered a poison pill in the Senate." A Senate Republican aide on Friday said the proposed measure is "dead on arrival in the Senate," adding, "The House acted like senators were comfortable with this and that is absolutely not true" (Edney, CongressDaily, 9/19). "Here in the Senate, there are at least five or six senators with well-known, longstanding objection to the specialty hospital pay-for," a Republican aide said.

Spokespeople for Sens. Tom Coburn (R-Okla.) and Kay Bailey Hutchison (R-Texas) on Friday confirmed that the inclusion of the offset measure would be an issue in the Senate, CQ Today reports. Don Tatro, a spokesperson for Coburn, said, "If they put the specialty hospital provision in that bill, Dr. Coburn will do all that he can to see that it does not get done this year. There will be no mental health parity bill if they do this," adding, "If they leave specialty hospitals out, they're OK."

Democrats were considering eliminating the specialty hospital ban provision and adding less controversial offsets, including one addressing corporate interest income, CQ Today reports (CQ Today, 9/19).