Support Grows for Delaying 2-Midnight Rule
A bill that would further delay enforcement of CMS’s 2-midnight rule has garnered the support of almost 70 members of the House of Representatives. The measure, introduced by Rep. Jim Gerlach (R-PA), would extend the current enforcement delay an additional six months to October 31, 2014 and implement a new inpatient stay policy in FY 2015. A similar proposal was included in last December’s “doc fix” legislation that extended use of the Sustainable Growth Rate (“SGR”) formula through March 31, 2014, but it was removed after the Congressional Budget Office (“CBO”) unofficially estimated that it would cost $2 billion. While supporters of the Gerlach bill hope to make it part of the SGR repeal legislation currently moving through Congress, its prospects for inclusion are poor if CBO doesn’t significantly reduce its cost estimate.
The Hill Names Hall Render to Its Top 10 List
On January 27, The Hill ranked Hall Render 8th on its 2013 top 10 list of lobbying firms based on the number of new client registrations. While it ranked just behind such venerable firms as Patton Boggs and K&L Gates, it was ahead of other established firms, including Hogan Lovells US, the Podesta Group and Akin Gump Strauss Hauer & Feld. The recognition is especially rewarding for the attorneys in Hall Render’s Federal Legislative & Regulatory Advocacy practice group, which was created in 2012. “We are thrilled to be in the company of such esteemed lobbying firms and would like to thank the clients who made it possible,” said John Williams, leader of Hall Render’s federal advocacy practice group. “To make such a list in less than two years spells great things for our firm’s future in Washington, D.C.”
Permanent SGR Reform Continues to Make Progress
This week, Congress continued to make progress in its effort to repeal and replace the SGR formula. According to those involved in the negotiations, the three committees responsible for the legislation are close to resolving their differences over a new policy that will set Medicare physician payment rates. However, lawmakers have yet to begin the difficult process of agreeing on how to pay for the measure. On January 24, the CBO scored the House Ways and Means Committee bill at a cost of $121 billion over 10 years. While it is the cheapest of the three proposals, it does not include a significant physician payment increase during the transition period or Medicare “extenders” like the low-volume hospital adjustment or ambulance add-on payments.
GOP Senators Introduce ACA Replacement Plan
On January 27, Sens. Orrin Hatch (R-UT), Tom Coburn (R-OK) and Richard Burr (R-NC) released a legislative outline to repeal and replace the Affordable Care Act (“ACA”). The proposal, which doesn’t include legislative language or an official cost estimate, repeals all of the ACA except for its changes to Medicare. The plan would issue tax credits to people who are not employed by a large company, allow states to establish state high-risk pools and dramatically reshape the nation’s Medicaid program. It would be paid for by capping the tax exclusion for employee health plans.
The proposal has no relationship to any looming Democratic-supported ACA reform that could emerge this year. While the Republican proposal has no chance for action this year, it could emerge next year if Republicans gain a Senate majority in the November 2014 elections.
CMS Announces ACO Savings
On January 30, CMS announced early results from its initiatives on accountable care organizations (“ACOs”). According to CMS, nearly half of the 114 ACOs had lower expenditures than expected, with 29 receiving bonuses (shared savings), totaling $128 million in savings for the Medicare program. The results come as Congress has indicated it may tinker with the rules of the ACO program. It is believed that incoming Senate Finance Chairman Ron Wyden (D-OR) is considering an approach that would give doctors a lump-sum payment and make it easier to provide services that might be covered by Medicare.
Bills Introduced This Week
There were no relevant health care-related bills introduced this week.
Next Week in Congress
The House and Senate return February 3 after a truncated week due to a two-day Republican policy conference. The House and Senate health committees will continue to mull over payment options for the SGR overhaul. While a list of possible payment offsets emerged this week, many will face strong objections from Medicare providers.
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.
