MedPAC Submits June Report to Congress
On June 14, the Medicare Payment Advisory Commission (“MedPAC”) submitted its annual June report to Congress on Medicare and the Health Care Delivery System. The Commission estimated that Medicare payments to doctors will be cut by 24.4% on January 1, 2014 if Congress does not pass legislation to correct the Sustainable Growth Rate (“SGR”) formula (also known as “doc fix”) before the end of the year.
Other highlights of the report include recommendations that Congress refine the hospital readmissions reduction program and equalize payments between physician offices and hospital outpatient departments and between physician offices and ambulatory surgical centers. The first measure would reduce hospital outpatient payments by $500 million, and the second would reduce hospital payments by $590 million. Both reductions would come through cuts to Evaluation and Management Services.
While MedPAC recommendations are not binding, the report fulfills MedPAC’s legislative mandate to make semi-annual recommendations to lawmakers on Capitol Hill, where those recommendations are taken very seriously.
Key Health-Related Committees Call for Stakeholder Input on Post-Acute Care
On June 19, the House Ways and Means and Senate Finance Committees issued a joint letter asking for stakeholder input on how to strengthen post-acute care for Medicare patients. The six-page letter seeks policy proposals from the health care industry and others to improve payment accuracy, combat fraud and address variation in utilization. The letter also emphasized the committees’ growing frustration with the current variation in spending, utilization and margins within the post-acute sector. The letter does not mention the SGR formula.
When Congress last patched the SGR, hospitals paid for the brunt of the fix. Many health insiders think post-acute hospitals might face similar cuts were Congress to enact another patch. Post-acute care includes recovery in long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities and home health agencies.
Ways and Means Holds Hearing on 2013 Medicare Trustees Report
On June 20, the House Ways and Means Health Subcommittee held a hearing on the recently released 2013 Medicare Trustees report. The subcommittee heard from two members of the Board of Trustees regarding their 2013 report’s analysis of the Medicare program. The witnesses cautioned Congress that, despite the recent slower-than-expected growth in national health care spending, the trend could go either way in future years.
The May 31 report estimated that Medicare’s hospital insurance trust fund will be insolvent by 2026, two years later than 2012 projections. However, the witnesses noted that Medicare’s total actual costs are likely to be higher than the trustees’ report projected – in part because the report is based on current law, which holds that Medicare physicians will have their payment rates cut by 25% after December 31.
Bill Would Redefine “Full-Time” Employee Under ACA
Sen. Susan Collins introduced a bill (S. 1188) that raises the health care law’s definition of full-time work from 30 to 40 hours a week. The legislation attempts to clarify which employers are considered “large” under the law. The legislation would set the number of hours counted toward a full-time equivalent employee to 174 hours per month.
Bills Introduced This Week
S. 1180: Sen. Chuck Grassley (R-UT) introduced legislation that would make Medicare claims data public. The bill would require federal officials to set up a database that the public could use for free to search for payments to physicians.
S. 1184: Sen. Tom Carper (D-DE) introduced legislation that would allow Medicare to cover the kinds of weight-loss control medicines that Medicaid covers in some states. Currently, weight loss surgery is the only obesity treatment that Medicare covers. Identical legislation was also introduced in the House.
H.R. 2375: Rep. Thompson (R-PA) introduced a bill that would delay, for at least six months, the implementation of round two of the Medicare durable medical equipment competitive bidding program. The delay would allow for evaluation of the program by a team of health professionals.
Next Week in Congress
On June 26, the Energy and Commerce Subcommittee on Health will hold a hearing to examine proposals to redesign the Medicare program’s benefit structure. The subcommittee previously discussed ideas for changing Medicare’s benefit design at an April 11, 2013 hearing.
For more information, please contact John F. Williams, III at 317-977-1462 or jwilliams@hallrender.com.
