Congress Avoids Government Shutdown, Continues Work on Budget
On March 20, the U.S. Senate approved a $984 billion continuing resolution (“CR”) that will fund the government through September 30, 2013, the end of the 2013 Fiscal Year. The bill is similar to the bill that passed the House earlier in the week and is expected to reach the President’s desk before federal agencies are set to close on March 28, when current funding expires.
Not included in the House or Senate CRs were the additional $949 million the Obama Administration requested for CMS to fully implement the Affordable Care Act. The final CR legislation is expected to retain the $85 billion in automatic spending cuts that took effect March 1, including the 2% reduction to providers’ Medicare payments.
Following the government funding vote, the Senate immediately pivoted to the budget debate, which is expected to run into the weekend. Senate Democrats say their plan would reduce the deficit by $4 trillion and includes almost $1 trillion in new taxes. Given that budget resolutions only need a majority of votes, the Democrat plan is expected to pass. However, it is unlikely to be reconciled with the House-passed budget and become law.
The House resolution, which passed on party lines, would offer a premium-support structure in Medicare starting in 2024. It would also cut more than $750 billion from Medicaid over 10 years and transition the program into block grants for states.
Bill Seeks to Ease Medicare Audit Burden
On March 18, a bipartisan bill was introduced that would cap the number of document requests possible during audits of Medicare providers suspected of improper payments. Rep. Sam Graves (R-M) and Rep. Adam Schiff (D-CA) reintroduced the Medicare Audit Improvement Act, H.R. 1250, citing the challenges for hospitals buried in requests from Recovery Audit Contractors.
The bill would limit the number of “additional document requests” to 2% of hospitals’ claims, with a maximum of 500 per 45 days. It would also penalize auditors that ignore basic audit requirements and courtesies. Additionally, the bill would give hospitals the option to rebill denied claims as outpatient under Medicare Part B and have them treated as original claims. The bill was previously introduced in the last Congress but failed to become law.
Senators Express Concern over Proposed Changes to Medicare Advantage
A group of 22 senators sent a letter to CMS expressing concern about proposed changes to a quality improvement program and the way the agency is projecting medical costs.
The senators, 11 Republicans and 11 Democrats, urge CMS to assume that Congress will address the Sustainable Growth Rate cut to provider pay as it has every year for the past decade, meaning that plans will have to pay doctors more than CMS is projecting.
The letter also argues that changes in CMS’s star rating program, which rewards high-performing plans with bonus payments, will lead to plans scoring lower than they have recently and that those changes should be postponed. More than 90 House lawmakers sent a similar letter to CMS last week.
Bills Introduced in Congress This Week
S. 577: Sen. Bill Nelson (D-FL) introduced a bill that would create 15,000 more medical residency positions under Medicare over the next five years. The bill is the Senate companion bill to H.R. 1201, which was introduced by Rep. Aaron Schock (R-IL) last week. In addition to creating new residency positions, the bill would give first preference in funding to hospitals in states with new medical colleges.
S. 596: On March 20, Sen. Thune (R-SD) introduced S. 596, the Fostering Independence Through Technology Act. The bill would establish shared savings pilot projects under the Medicare program. These projects would incentivize home health agencies to purchase and utilize remote patient monitoring and communications technologies. The bill requires that pilot projects be conducted in both urban and rural areas and that at least one project be conducted in a state with a population of less than one million.
H.R. 1326: Rep. Michael Burgess (R-TX) introduced a bill that would amend Title XIX of the Social Security Act to provide for increased price transparency of hospital pricing information. The bill would also provide for additional research on consumer information on charges and out-of-pocket costs. The bill was referred to the House Energy and Commerce Committee.
H.R. 1390: Rep. Christopher Smith (R-NJ) introduced a bill that would amend Title XVIII of the Social Security Act to preserve access to urban Medicare-dependent hospitals. The bill was referred to the House Ways and Means committee.
For more information, please contact John F. Williams, III at 317-977-1462 or jwilliams@hallrender.com.
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