Permanent “Doc Fix” Sustainable Growth Rate Deal Possible As Deadline Looms
March 13, 2015 01:07 PM
With the last Sustainable Growth Rate (“SGR”) “patch” set to expire on March 31, 2015, lawmakers on Capitol Hill must soon decide whether to pass another “patch” or to finally tackle the issue of permanent SGR repeal and replacement. Just last week, House Majority Leader Kevin McCarthy (R-CA) and House Ways and Means Committee Chairman Paul Ryan (R-WI) told attendees at the annual Federation of American Hospitals meeting in Washington, D.C., that permanent repeal and replacement was off the table.
However, although details are scarce, NAHC government affairs has learned that a last minute deal to permanently repeal and replace the Medicare physician payment formula is currently under review by House and Senate leadership to determine whether there are enough votes for passage.
The package being discussed by House leaders in both parties would partially pay for the cost of the $210 billion fix over 10 years and could include Children's Health Insurance Program (CHIP) funding and supplemental Medicare payments known as “extenders.” The offset to partially pay for the package ranges from $70-80B.
The likely offsets include a reduction in the Medicare rate updates in 2018. The reduction appears to be about a 1 point reduction in the inflation update (Market Basket Index) and both hospice and home health service providers would be affected. However, the measure does not include a home health copay or any cost sharing reform that would lead to a home health or hospice copay or coinsurance obligation for beneficiaries.
NAHC is working to include the rural add-on extension in the measure along with a remedy for the face-to-face physician encounter requirements. NAHC is also trying to include a more targeted approach to a spending reduction than the across-the board rate cut. For example, these options include a Value Based Purchasing program that incentivizes high quality care.
Please stay tuned for further details and NAHC Action Alerts.