CMS Releases DSH Allotments
On February 27, CMS posted its fiscal year 2014 preliminary funding allotments to states for Medicaid Disproportionate Share Hospitals (“DSHs”). DSH funds were slated to be cut this year under the Affordable Act (“ACA”), but the cuts were delayed in December when Congress passed the Bipartisan Budget Act of 2013.
Negotiated SGR Bill Would Cost $138 Billion
On February 27, the Congressional Budget Office (“CBO”) released a score on the negotiated SGR legislation. According to CBO, the repeal-and-replace legislation, which was agreed to by three congressional committees in early February, would cost $138.8 billion through 2024. The agency noted this estimate was an 11-year score whereas previous scores only included costs through a 10-year period.
The score comes in lower than previous versions of the legislation, which ranged up to $153 billion over 10 years. Despite the lower than expected score, Congress has only one month before the current “doc fix” patch expires and physicians face a cut in their Medicare reimbursement rates beginning April 1. To prevent the cut, committees are working on a short-term patch that could last through the rest of 2014.
Senate Bill Seeks to Eliminate 96-Hour Rule for CAHs
Senators Pat Roberts (R-KA) and Jon Tester (D-MT) introduced legislation seeking to protect Critical Access Hospitals (“CAHs”) by eliminating new “condition of payment” rules from CMS that require a physician to predict and limit a patient’s stay to within 96 hours. The Senate bill is a companion bill to H.R. 3991, which was introduced earlier this month in the House.
Under current law, physicians must certify that patients admitted to a CAH will be discharged or transferred to another hospital within 96 hours for the CAH to receive reimbursement under Medicare Part A. The legislation would not remove the requirement that CAHs maintain an average annual length of stay of 96 hours, nor affect other certification requirements for hospitals.
CMS Proposes 1.9% Cut in 2015 MA Rates
On February 21, CMS proposed a 1.9% cut in Medicare Advantage payments. CMS indicated their preliminary estimate is the combined effect of the Medicare Advantage growth percentage and the fee-for-service growth percentage. Similar to last year, the proposed cut was met with criticism from House and Senate Republicans and insurers.
In 2013, Medicare officials initially proposed reducing Medicare Advantage payments by 2.2%, but the final rule raised the rate by 3.3%. The final Medicare Advantage payment rates for 2015 are scheduled to be released April 7. Given the politics surrounding the issue, many are expecting a net reduction that is smaller than the proposed rate.
Providers Want EHR Program Delayed
In a letter to HHS Secretary Kathleen Sebelius, 48 provider groups asked the Secretary to delay requirements through 2015 for Stage 2 of the meaningful use program for electronic medical records. The requirements are set to take effect this fall for approximately 5,000 hospitals who will then be required to either meet them or face significant penalties. HHS has already extended the start of Stage 3 until 2017.
Bills Introduced This Week
Senator Sherrod Brown (D-OH) introduced a bill (S. 2046) to amend title XVIII of the Social Security Act to provide Medicare beneficiaries coordinated care and greater choice with regard to accessing hearing health services and benefits.
Next Week in Congress
The administration will release their annual budget proposal that outlines long-term fiscal suggestions and fiscal 2015 spending requirements for federal agencies and programs.
For more information, please contact John F. Williams III at 317.977.1462 or jwilliams@hallrender.com.
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