House Passes Massive Government Spending Bill
On Wednesday, the House passed a $1.1 trillion government-wide spending bill. The bill (H.R. 3547), which passed 359-67, establishes the discretionary spending level for the fiscal year and should end the threat of a government shutdown for much of the remainder of 2014.
As part of the deal, congressional appropriators included several CMS directives. In particular, Congress asked CMS to provide a list of critical access hospitals (“CAHs”) that would be re-designated under the administration’s proposal to remove CAH status from facilities located less than 10 miles from another hospital. In August 2013, an HHS Office of Inspector General (“OIG”) report stated that nearly two-thirds of CAHs would not meet the location requirements if they were required to re-enroll.
The legislation also directs CMS to put mechanisms in place to ensure Recovery Audit Contractors (“RACs”) adhere to CMS policy. This policy directive comes after an HHS OIG October 2013 Report said fewer providers and beneficiaries are winning Medicare appeals as RAC denials have increased.
The spending bill now moves to the Senate. Although debate there will likely be more contentious, the measure should be approved by the January 18 deadline.
MedPAC Recommends 3.25% Update for Hospitals
On Thursday, the Medicare Payment Advisory Commission (“MedPAC”) recommended to Congress that HHS boost payment rates for acute-care hospital inpatient and outpatient prospective payments systems by 3.25% in fiscal year 2015. This is a 3.2% increase over December’s draft recommendation and an increase over last year’s 1% recommendation.
MedPAC noted it did not factor in the 2% sequester adjustment, which remains in effect absent legislation. Commission Chairman Hackbarth said the panel believes Congress should repeal Medicare cuts imposed by the sequester because targeted policies are more appropriate than broad-based reductions.
The recommendations are among several hospital payment-related recommendations that the panel approved. The final recommendations will be included in MedPAC’s March report to Congress. While MedPAC recommendations have no legislative authority, Congress generally gives serious consideration to MedPAC recommendations.
Senate Clears Poison Control Programs Bill
On Tuesday, the Senate passed a bill to reauthorize funding for poison control programs, including a national toll-free poison control hotline. The bill (H.R. 3527), which passed the House on January 8, would authorize nearly $29 million annually from FY 2015 through FY 2019 for a poison control grant program that poison control centers could use for certain communication improvements. The bill now heads to the President’s desk for signature.
Medicare to Disclose Physician Reimbursement Data
On Tuesday, HHS announced it would begin responding to Freedom of Information Act requests for physician-payment data. HHS said it would begin using a “balancing test” to determine which Medicare physician-payment data should be released. As part of the new policy, CMS will also begin publishing “aggregate” data sets about Medicare physician services. The new policy becomes effective 60 days after it appeared in the Federal Register.
Bills Introduced This Week
Incoming Senate Finance Chairman Ron Wyden (D-OR) introduced the Better Care, Lower Cost Act (S. 1932) that would give providers and insurance plans incentives to use team-based care to treat patients with chronic health conditions. The legislation would establish a voluntary program that would allow Medicare providers to receive new risk adjustments, capitated payments and rewards for better outcomes. It would also use telemedicine and knowledge networks to provide better access to care in rural areas.
Next Week in Congress
The House and Senate will not be in session next week. Both chambers return on January 27 with the President’s State of the Union Address scheduled for January 28.
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