House and Senate Committees Reach Agreement on SGR Bill
February 7, 2014 08:58 AM
Negotiators from the House Energy and Commerce and Ways and Means Committees as well as the Senate Finance Committee reached an agreement on a bill to replace the flawed Medicare physician payment formula known as “SGR” – incorporating aspects from the three competing versions. The compromise agreement does not include any language on extending certain Medicare policies, known as “extenders,” nor on offsets to pay for the legislation.
Congressional leaders are hoping for congressional action on this bill before the most recent SGR patch - which was approved last month - expires on March 31, but the effort to find offsets promises to be daunting.
Key changes that were incorporated into the final SGR repeal bill include:
0.5 percent increase in physician payments for 5 years before the alternative physician payment models take effect
Making the targets in the incentive-based program more clear
Allowing podiatrists, optometrists, and chiropractors to participate in the first year of the alternative payment models
Provides $40 million in each of 5 years for technical assistance to offices with 15 or fewer professionals
Capping of the payment adjustment at 9 percent instead of 12 percent
The compromise SGR bill did not include any offsets to pay for the SGR replacement, though staff from both committees indicated that they will continue to have discussions on offsets and Medicare extenders, including the non-SGR amendments that were accepted during the markup of Senate Finance Committee late last year.
The Senate Finance Committee approved its version of an SGR bill that included two provisions beneficial to the home health and hospice community late last year, but the threat of finding offsets to pay for the SGR fix could jeopardize access to home health and hospice services if negotiators propose home health or hospice payment cuts or copays to pay for the SGR in the bill’s final version.
For more on the Senate’s SGR bill, please see NAHC Report, December 17, 2013.
While no offset proposals have yet been formally endorsed by either chamber, the Senate Finance Committee recently compiled a list of possible offsets. Several of the proposals - coming from President Obama’s 2013budget or from the Simpson-Bowles Commission – pose a serious threat to the home health and hospice community.
Specifically, the list of potential offsets includes:
A 1.1 percentage point cut in the inflation update over ten years for Medicare post acute providers, including home health providers (President’s budget)
A $100 home health copay on episodes not preceded by a hospital or nursing home stay, beginning in 2017 and applied to new Medicare beneficiaries (President’s budget)
Combining Medicare Parts A and B and imposing a uniform 20 percent copay on all Medicare services, including home health and hospice (Simpson-Bowles proposal)
The list also includes a post acute care bundling proposal from the President’s budget.
For more on the above proposals included in President Obama’s budget, please see NAHC Report, April 16, 2013.
For more on the above proposals included in the Simpson-Bowles Commission Report, please see NAHC Report, February 20, 2013.
To send a message opposing proposals to use home health and hospice payment cuts and copays to pay for the SGR replacement, you may go to the NAHC Legislative Action Network.
For home health, please click here.
For hospice, pleaseclick here.
The SGR bill will likely be coming to a head in Congress at the time that NAHC’s March on Washington is being held this year and before the current SGR patch is set to expire.
Given the real and looming threat that efforts to offset the cost of the SGR bill could have for the home health and hospice community, NAHC strongly urges all of its members to attend this year’s March and plead the case in person to lawmakers to oppose home health or hospice payment cuts or copayments to pay for the SGR replacement.