CBO Scores Chairman Wyden’s SGR Bill
On March 19, the Congressional Budget Office (“CBO”) announced that the SGR repeal bill (S. 2110) being advanced by Senate Finance Committee Chairman Ron Wyden will cost $180.2 billion over an 11-year period from 2014-2024. The estimate includes the cost of permanently extending several Medicare programs, such as the Low Volume Hospital Adjustment or Outpatient Therapy Caps, which were not included in the original Senate bill offered by the Finance Committee.
On March 14, the House passed an identical bill to S. 2110 but without the Medicare extenders. The House bill (H.R. 4015) is paid for by suspending the ACA’s individual mandate for five years, which Senate leaders have already rejected. Senate staff have indicated the current impasse will lead to a 9- to 12-month extension of the SGR that will go past the midterm elections in November. Under Medicare’s existing payment system, physicians face a 24% pay cut on April 1 if Congress does not extend or enact a new payment system.
Ranking Member on Health Committee Urges HHS to Modify RAC Program
Rep. Jim McDermott (D-WA), the top Democrat on the Ways and Means Committee, says HHS, not Congress, should revamp the Recovery Audit Contractor (“RAC”) program and address the 2-midnight hospital admission policy. In a letter sent to HHS on Tuesday, McDermott called for CMS to penalize RACs for overturned appeals linked to the 2-midnight hospital inpatient admissions process.
McDermott wrote that he is not supportive of legislative reforms to the current program and prefers that steps be taken administratively without intervention by Congress. Despite the McDermott letter, there is interest on Capitol Hill for an additional delay of the 2-midnight rule and RAC program to be included in the “doc fix” extension that is expected to pass at the end of the month. Last month, CMS delayed enforcement of the 2-midnight rule and extended limits on RAC review of short-stay inpatient hospital admissions until September 30, 2014.
Bipartisan Proposal for Post-Acute Payment Reform Released
On March 18, leaders of the Senate Finance and House Ways and Means Committee released a bipartisan discussion draft of a bill that would improve Medicare payments to providers caring for patients recovering from a serious illness. The legislative draft focuses on gathering standardized, accessible information, which would be required from providers by the 2019 payment year, in order to: (1) compare quality across post-acute care settings; (2) improve hospital and post-acute discharge planning; and (3) reform post-acute care payments based on this standardized date.
According to committee staff, the draft bill is based on recommendations from more than 70 key health care groups. Committee leaders said they plan to make further changes to the measure and eventually use it to introduce formal legislation. While the draft outlines a slow reform process, it also signals that post-acute payment reform is of significant interest to Congress.
Bills Introduced This Week
No legislation was introduced this week as the House and Senate were in recess.
Next Week in Congress
The House and Senate return from recess next week. At the top of the health care agenda will be finding a temporary payment solution for the Medicare physician payment system. On Wednesday, the Senate Aging Committee will hold a hearing on Medicare Fraud, and the House Energy and Commerce Committee will hold a hearing on psychiatric care.
For more information, please contact John F. Williams III at 202.442.3780 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.
