Delayed Debt Ceiling Could Affect Provider Payment Bill
The Congressional Budget Office (“CBO”) released their June report showing the government should be able to stay under the debt ceiling until October or November of this year. Many inside health circles believe that Congress will feel less pressure to fix the Sustainable Growth Rate (“SGR”) formula, which determines physician pay, if Congress has until this fall before hitting the debt ceiling. The debt limit was actually reached in May, but the Treasury Department is using “extraordinary measures” to avoid the ceiling.
The House Energy and Commerce Committee Chairman Fred Upton (R-MI) indicated this week that he’s confident the committee will approve a bipartisan bill replacing the physician payment formula in the next couple months. While the committee has offered a draft legislative framework, a solution on how to offset the 10-year, $139.1 billion cost for SGR repeal has not been offered.
On the Senate side, Finance Committee Chairman Max Baucus (D-MT) has indicated a rewrite of the tax code as the source of offsets for the SGR fix. However, few believe any tax overhaul could be completed before the next physician payment cut is set to take effect January 1, 2014. This could mean other Medicare providers are potential targets for cuts in 2013 to block physician payment cuts.
Ways and Means Chair Opposes Charitable Deduction Cap
At an annual health policy summit in D.C., Ways and Means Committee Chairman Dave Camp (R-MI) said “it’s important not to cap” the tax deduction for charitable donations, including those to hospitals, saying philanthropy is a way to fund research and education. Since taking office, the Obama Administration has called for a substantial reduction in the charitable deduction to hospitals and other nonprofit entities.
House Hearing Examines Post-Acute Pay
On June 14, the House Ways and Means Health Subcommittee held a hearing to examine varying proposals to cut Medicare spending by tens of billions of dollars over ten years through post-acute care payment reform. One of the focuses of the hearing was on the lack of guidelines for placing patients in post-acute facilities when they are discharged from hospitals.
The hearing coincided with the release of the annual June report by the Medicare Payment Advisory Commission, which has long advocated for post-acute payment reform.
Medicare Fraud Intervention Measure Introduced
On June 11, two Democrats and two Republicans introduced legislation (H.R. 2305) intended to curb waste and fraud in Medicare and Medicaid. The Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013 toughens penalties for individuals committing fraud, attempts to phase out so-called “pay and chase” practices used by recovery audit contractors and encourages more data sharing among federal agencies to detect and prevent fraud. The primary sponsors are Rep. Peter Roskam (R-IL), Rep. John Carney (D-DE), Sen. Tom Carper (D-DE) and Sen. Tom Coburn (R-OK).
Bills Introduced This Week
S. 1143: Sen. Jerry Moran (R-KS) introduced legislation that would allow general supervision by a physician or non-physician practitioner for many outpatient therapy services. The legislation would require CMS to allow a default setting of “general supervision” rather than “direct supervision” for outpatient therapy services. The legislation would hold hospitals and critical access hospitals harmless from civil or criminal action for failing to meet the “direct supervision” requirements applied to services furnished since 2001.
H.R. 2329: Rep. Adrian Smith (R-NE) introduced legislation that would amend Title XVIII of the Social Security Act to provide for a maximum period of two years for submissions of Medicare Part B claims originally submitted by hospitals as Medicare Part A claims. The bill was jointly referred to the House Ways and Means Committee and Energy and Commerce Committee.
S. 1137: Sen. Ron Wyden (D-OR) introduced a bill that would amend Title XVIII of the Social Security Act to modernize payments for ambulatory surgical centers under the Medicare program.
Next Week
On June 20, the House Ways and Means Health Subcommittee will hold a hearing on the recently released 2013 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. This hearing will focus on the Medicare program’s financial status and changes from the Trustees’ previous reports and hear testimony from Medicare’s two public trustees.
For more information, please contact John F. Williams, III at 317-977-1462 or jwilliams@hallrender.com.
Please visit the Hall Render Blog at http://blogs.hallrender.com/ for more information on topics related to health care law.
