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Mar. 26—Congressional leaders have agreed to pass a one-year extension of current Medicare physician pay rates this week, House Speaker John Boehner said Wednesday.
Boehner, a Republican, said at his daily press conference that he and Senate Majority Leader Harry Reid, a Democrat, agreed to the plan, and both chambers will vote this week. A temporary patch to prevent a 24 percent cut called for by Medicare’s sustainable growth rate formula (SGR) expires March 31.
Work could continue during the one-year extension on a permanent replacement to the SGR, Boehner said.
The patch was sure to disappoint physicians who have pushed a bipartisan deal to replace the SGR with a system that moves away from fee-for-service payments and toward payments based on the quality of care delivered. That proposed legislation stalled, however, when no bipartisan option was found to cover its $138 billion, 10-year cost.
The SGR was designed in the 1990s as a way to control Medicare spending growth, but Congress has blocked cuts called for by the formula numerous times since then. The last-minute, and sometimes retroactive, blocks to the cuts have left physicians facing deep uncertainty over Medicare payments.
"What there isn't agreement on is, how are we going to pay for it?" Boehner said, according to news reports.
The House recently passed a permanent so-called “doc fix,” which was funded through a five-year delay in the tax penalty owed by most Americans if they fail to purchase qualifying health insurance coverage, as required by the Affordable Care Act.
Senate Democrats prefer using savings they cite from the drawdowns in Iraq and Afghanistan to pay for the bill. Both parties oppose the funding approach favored by the other, and the White House has promised a veto of the Republican approach.
Hospitals Benefit Under Proposed Legislation
The proposed legislation containing the SGR patch also includes both extensions of expiring payment provisions and delays in cuts in future payments to hospitals.
Among the biggest potential impacts on hospitals could be a six-month extension—to April 1, 2015—of the so-called probe-and-educate limited enforcement of the new two-midnight admissions rule.
The bill also pushed back by one year—to 2017—the start of cuts in Medicaid disproportionate share hospital payments. The cuts also would continue one year longer—to 2024.
The changes were described as a potential “modest positive for the group” in a Wednesday report by Bank of America Merrill Lynch.
Additionally, the bill would extend to April 1, 2015:
The bill also would delay for another year—until Oct. 1, 2015—the movement to ICD-10 code sets.
Publication Date: Wednesday, March 26, 2014
Brian Kueppers, founder and CEO, Apex, discusses the importance of a robust patient payment strategy in boosting organization revenue and enhancing patient satisfaction.
Brian Grazzini, CFO, HealthPort, describes the importance of efficient and compliant information exchange and audit management in helping HIM staff spend less time on paperwork and more on mission-critical projects.
Cindy Matthews, executive vice president, Community Hospital Corporation, discusses how rural and community hospitals can use collaborative partnering to position for success through tough market conditions.
Rick Heise, senior vice president, revenue cycle, at Cerner Corporation, discusses the importance of integrating clinical and financial data to excel in health care’s changing payment environment.
Dale Hockel, senior vice president of operations, and Jim Fanelli, CFO, TriMedx, share strategies for elevating clinical engineering through innovative management programs.
Russ Graney, founder and CEO for Aidin, and John Laursen, head of business development for Aidin, share insights on how to improve care transitions between acute and post-acute care settings and incentivize high-quality patient outcomes.
Scott Elston, strategic accounts manager, GE Healthcare Services, describes how substantial cost reduction in health care requires rethinking business strategy and asset use.
Robert Williams, MD, director, Deloitte Consulting LLP, and Arielle Freiberger, product strategist, ConvergeHEALTH by Deloitte, explain how sophisticated retrospective, real-time, and predictive data analytics can inform decision making to reduce costs and improve care.
Stuart Hanson, director of business development (healthcare solutions) at Citi Retail Services, discusses how improving the payment experience can benefit consumers and healthcare providers.
Scott Schmidt, vice president, Cerner RevWorks, LLC, shares insights on best practices for maximizing a revenue cycle management partnership.
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