NAHC Members Urged to Contact their Elected Officials During Ongoing Budget Conference Committee Negotiations and Congressional Efforts to Fix Medicare Physician Payment Formula
November 13, 2013 04:36 PM
A Congressional budget conference committee is currently attempting to negotiate discretionary spending levels for next year, with a deadline of December 13 to report back to Congress. As part of these discussions, suggestions have been made to substitute some mandatory spending cuts, such as from Medicare and Social Security, for some of the discretionary spending cuts under the sequester. There is, however, significant opposition to this idea, and continues to be talk of some “grand bargain” of long term mandatory spending cuts. A grand bargain seems unlikely in the current impasse between Republicans vowing not to raise taxes and Democrats vowing not to do any grand bargain without some new revenues.
Concurrent with these budgetary developments, work continues on fixing the flawed Medicare physician payment formula, known as the sustainable growth rate or SGR. Estimates for a permanent fix range from $139 billion to $175 billion over ten years. Finding offsets from Medicare for this level of spending is very daunting - with most betting that Congress will do another one year patch, which is estimated to cost between $20 to $30 billion, depending on how much is spent on extending other policies such as the therapy cap exceptions process.
Last year nursing homes and hospital payments were cut to help pay for a one-year physician fix -- home health care and hospice were spared. Congress must take action on the physician fix by year’s end, or shortly thereafter, to prevent a 25 percent cut in physician payments.
As you may recall, the President put forth two proposals that directly affects home health care in his budget proposals:
1. A 1.1 percentage point reduction in the inflation update over ten years for post acute providers, including home health care, and;
2. A $100 copay on home health episodes not preceded by a hospital or nursing home stay, beginning in 2017 and applying to individuals who become eligible for Medicare in 2017 and beyond. House Republican leaders drafted legislation that includes these proposals from the President’s proposed budget. The Congressional Budget Office released its updated budget options for reducing the deficit today, which includes home health and hospice copays as an option.
NAHC has updated its Legislative Action Network (NAHC LAN) to reflect these developments. Please take a moment to send a message to your Senators and Representative urging them to reject any proposal to use home health or hospice payment cuts and copays as a means to offset the cost of the physician fix, for deficit reduction, or other purposes.
For home health, go here: Write Your Legislators.
For hospice, here: Write Your Legislators.
NAHC’s Legislative and Advocacy team would also like to thank all members who participated in the Annual Meeting’s Lobby Day late last month - both in person and virtually.
Further developments on these issues will be covered in future editions of NAHC Report.