House Subcommittee Holds Hearing on the Sustainable Growth Rate

On July 18, NASS staff attended a House Energy and Commerce Sub-Health Committee hearing on the various ways Congress should address the looming threat of cuts to reimbursements that the current Medicare physician payment formula places on providers. Both Republicans and Democrats at the hearing agreed that the current payment formula needs to be replaced, but grappled with identifying a funding source for a new system and the elimination of the 27.4 percent cuts to physician reimbursements.

The Subcommittee listened to testimony from a panel of witnesses mostly representing physician groups and private payers. In their testimony, the witnesses offered a series of recommendations for the committee to consider as it looked for ways to replace the current payment system. Scott Serota, President and Chief Executive Officer BlueCross and BlueShield Association, urged the committee to consider looking at bundling payments as he described how a pilot program at Blue Cross and Blue Shield in New Jersey was working to control costs and allowed participating physicians to share in savings. Other witnesses, such as David L. Bronson, president, American College of Physicians, urged adoption of a medical model home.

At the hearing, Vice-Chair of the Sub-committee Rep. Mike Burgess, MD (R-TX) announced that he would introduce the Medicare Stability and Access for Seniors Act of 2012, which provides a one-year extension of current Part B reimbursements through the end of 2013. Congressman Burgess said he hoped Congress could pass this bill before the upcoming elections in November to give some certainty to physicians while Congress worked on legislation to reform the payment system. It’s unclear at this time if Rep. Burgess’ bill will pass as it does not contain a funding mechanism to pay for such an extension.

To access a recording of the hearing, click here.

To view H.R. 6412, the Medicare Stability and Access for Seniors Act of 2012 click here.

House Appropriations Panel Cuts Spending to PPACA in Bill

The House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies, approved a fiscal year 2013 funding bill that would eliminate spending to implement the health reform law and repeals existing funding from programs established under the law. If signed into law, the bill would provide $150 billion for Labor, Health, and Education programs over the next fiscal year, which begins October 1, and reduce spending levels in the programs by $6.3 billion over FY 2012 funding levels.

The measure, if cleared by the full House, is unlikely to be approved in the Democrat-controlled Senate, which has yet to approve any FY 2013 appropriations bills.

The bill’s reductions include:

  • a reduction of $409 million below the FY 2012 level for the CMS’ management and operations;
  • eliminating funding for the Agency for Healthcare Research and Quality (AHRQ);
  • eliminating funding for the Public Health and Prevention Fund;
  • a reduction of $453 million below the FY 2012 level funding for the Health Resources and Services Administration, which supports community health centers; and
  • a reduction of $194 million below the FY 2012 level for the Substance Abuse and Mental Health Services Administration.

The programs with increased FY 2013 funding or with funding equal to the FY 2012 level include:

  • an increase of $66 million above the FY 2012 level for the Centers for Disease Control and Prevention; and
  • equal funding to the FY 2012 level for the National Institutes of Health.

For more information about the bill, please click here.