Push for SGR Repeal Continues
The Senate Finance Committee will meet on December 12 to consider a bill to fully repeal the Sustainable Growth Rate (“SGR”). The legislation that will be offered by Finance Committee Chairman Baucus (D-MT) will be distributed 48 hours before the start of the markup. Although he has not identified which Medicare extenders will be considered by the committee, Sen. Baucus has indicated that a package of these health-related provisions will be addressed by the Committee.
The move is the latest in steps toward Congress fully repealing the physician pay formula. On October 31, Sen. Baucus and House Ways and Means Chairman Camp (R-MI) released a discussion draft outline on permanently fixing the SGR. The bipartisan proposal calls for a 10-year freeze and a performance-based incentive program beginning in 2017.
While this progress is a positive development, the House Ways and Means Committee has not yet scheduled a markup, and Congress is expected to recess for the year on December 13. Since failure to take some action would result in Medicare physician payments being cut by 24.4%, it is becoming more likely that lawmakers will seek another temporary reimbursement patch.
OMB Receives Final Rule on 2014 Physician Fee Schedule
On November 21, the White House Office of Management and Budget (“OMB”) received for review the final Medicare physician fee schedule rule for 2014 (CMS-1600-F). The 2014 rule, which has traditionally been published in early November, was delayed due to the 16-day federal government shutdown in October. CMS has indicated the final rule will be issued on or before November 27, 2013 and take effect on January 1, 2014.
Senate Invokes “Nuclear Option”
On Thursday, Senate Democrats invoked the so-called “nuclear option” and changed the Senate’s filibuster rules to allow for confirmation of most of President Obama’s judicial and executive branch nominees by a simple majority vote. The 60-vote threshold will remain intact for filibusters of legislation and Supreme Court nominations.
The Senate’s rule change will likely make it much easier for the Administration to fill the Independent Payment Advisory Board (“IPAB”). The IPAB, which was created out of the Affordable Care Act (“ACA”), is a 15-member panel tasked with slowing the growth of Medicare spending.
HHS to Delay 2015 ACA Enrollment by a Month
On November 21, HHS announced plans to delay the start of the second year of ACA enrollment by one month. The decision means that sign-ups for the 2015 plan year would begin on November 15, 2014 and end on January 15, 2015. The 2015 open enrollment season would start shortly after the November midterm elections. The change will not affect any coverage during the ACA’s first year, which is set to begin January 1, 2014.
Bills Introduced This Week
S. 1758: Sen. Tammy Baldwin (D-WI) introduced a bill that would amend title XVIII of the Social Security Act to allow organizations receiving Medicare data to analyze and redistribute it to authorized subscribers (insurers, health systems and physicians). The legislation would also permit those entities to charge a fee to their subscribers.
S. 1769: Sen. Pat Toomey (R-PA) introduced a bill that intends to limit the establishment of certain standards of care or duties owed by health care providers to patients in any medical malpractice or medical product liability action or claim.
Next Week in Congress
The House and Senate will be in recess next week for the Thanksgiving holiday. For more information, please contact John F. Williams, III at 317.977.1462 or jwilliams@hallrender.com.
