Rep. Boustany Introduces Bill to Allow Physician Incentive Payments
Meets with Hall Render to Discuss Stark Law Reform
On Wednesday, Rep. Charles Boustany, M.D. (R-LA), a retired cardiovascular surgeon, introduced the Aligning Incentives for Better Patient Care Act of 2012 (H.R. 6176), which was co-sponsored by Rep. Tom Price, M.D. (R-GA). The bill would revise the Stark Law to permit hospitals and physicians to enter into voluntary quality incentive agreements in which physicians are allowed to receive payments to promote quality and efficiency. The agreements must list specific clinical and nonclinical quality improvement activities and describe how payments to physicians are calculated. The bill also creates an exception for incentive payments, and a statutory safe harbor from criminal penalties, under the Civil Monetary Penalty law.
The morning after the bill was introduced, Hall Render Federal Affairs attorneys John Williams and Andrew Coats met with Congressman Boustany’s staff in his Capitol Hill office to discuss the bill’s prospects and Stark Law reform in general. Not surprisingly, Rep. Boustany believes the bill has very little chance of passing the House as “stand alone” legislation. However, the Louisiana Congressman serves as Chairman of the Ways and Means Oversight Subcommittee. As reported last week, Ways and Means Full Committee Chairman Dave Camp (R-MI) told Hall Render that, contrary to reports, fraud and abuse law reform may not be dead after all. Consequently, Boustany will be in position to offer the measure as an amendment to any health-related legislation that “moves out” of the Ways and Means Committee, including any bill to replace the Sustainable Growth Rate (“doc fix”) that must be adopted before the end of the year.
Hall Render will meet with Rep. Boustany in the coming weeks to provide additional data on Stark law reform and help coordinate support for the bill in Congress.
Senate Presses White House for Sequestration Details
On July 25, the Senate agreed to a House-passed sequestration reporting measure (HR 5872). The bill requires the White House to detail to Congress the impact of sequestration for defense and health-related programs, in particular how the funds will be sequestered. The sequestration report will be due within 30 days of the bill becoming law. The White House noted the President will sign the measure into law.
The White House Office of Management and Budget (“OMB”) would implement sequestration, but it has yet to announce how it would carry out the process. The sequestration, included in last year’s debt limit deal (PL 112-25), takes effect January 2, 2013, unless Congress passes legislation addressing the issue beforehand.
CMS Announces Payment Updates for Inpatient Rehabilitation Facilities for FY 2013
On July 25, CMS announced updated payment rates for Inpatient Rehabilitation Facilities (IRF) for FY 2013. CMS will increase payments to IRFs 2.1%. The new rates will apply to services furnished to Medicare beneficiaries with discharges on or after October 1, 2012.
The updated rates affect more than 200 freestanding IRFs and almost 1,000 IRF units of acute care hospitals, including a small number of IRF units in critical access hospitals that are paid under the IRF Prospective Payment System. CMS also says the department will issue future rulemaking on the IRF quality reporting program, slated to go into effect by FY 2014 under the Affordable Care Act.
The notice will be published in the Federal Register on July 30. It’s worth noting that an updated notice differs from a proposed rule and means that additional cuts or substantive new policy provisions are not included.
Ways and Means Committee Holds Second Hearing on Form 990
On July 25, the House Ways and Means Subcommittee on Oversight held their second hearing on tax-exempt organizations and Form 990. Similar to the first hearing in May, members heard from witnesses about the complexity of the recently redesigned Form 990 and the problems it creates for tax-exempt organizations. Expect legislation on Form 990 when Congress deals with tax reform after the November elections or next Congress.
CBO Revises Health Care Law Cost Estimate
On July 24, CBO and the Joint Committee on Taxation released estimates on the cost of the health care law as modified by the June 28 Supreme Court ruling. The analysis claimed the ruling allowing states to opt out of Medicaid expansion will result in 3 million more people remaining uninsured. The CBO report did not indicate how many or which states it expects to opt out of Medicaid.
CBO issued an additional study claiming the cost of repealing the health care law (HR 6079) would add $109 billion to federal budget deficits between 2013 and 2022.
GAO Report Finds Rural Hospitals Less Likely to Receive EHR Incentive Payments
On July 26, the Government Accountability Office (“GAO”) issued a report claiming small rural hospitals were less likely than urban hospitals to receive Medicare incentive payments for meaningful use of electronic health records (“EHR”) in 2011. GAO found that hospitals paid under the Inpatient Prospective Payment System were twice as likely as critical access hospitals to receive an incentive payment. Also, nonprofit and for-profit hospitals were 1.1 and 1.5 times more likely than government-owned hospitals to have been awarded an incentive payment. The report examined data from 2011, which was the first year of the Medicare EHR incentive payments program.
CMS Publishes FY 2013 Hospice Payment Update
On July 27, CMS published the FY 2013 Hospice payment update. According to CMS, hospices serving Medicare beneficiaries will see an estimated 0.9% increase in their payments for FY 2013. The hospice payment increase is the net result of a 1.6% increase in the hospital market basket update, offset by a 0.7% decrease in payments to hospices due to updated wage index data and the fourth year of CMS’s seven-year phase-out of its wage index budget neutrality adjustment factor. The new Hospice Wage Index is effective October 1, 2012.
Health Care-Related Bills Introduced
S. 3430: Senator Shaheen (D-NH) introduced legislation that would establish a commission of experts on diabetes care and prevention. According to the bill, the commissioners would identify gaps where new approaches are needed for diabetes care and assist in coordination of federal efforts to fight diabetes. Similar legislation (HR 2960) has been introduced in the House by Rep. Pete Olson (R-TX).
Next Week
The House and Senate return for their final week before the August district work period. House and Senate leadership will focus on passing a six-month continuing resolution that would keep the federal government open through March and avoid a potential September 30 shutdown. Continued battles over end-of-the-year tax extensions and the looming sequestration will also dominate the landscape next week.
For more information, please contact John F. Williams, III at 317.977.1462 or jwilliams@hallrender.com.
