Fate of “Fiscal Cliff” Deal Still Uncertain

On December 9, Speaker of the House John Boehner (R-OH) and President Obama capitol webresumed high-level talks at the White House for the first time in three weeks. While details of the meetings have remained behind closed doors, both the President and the Speaker have been tackling the greatest obstacles in achieving a grand bargain, mainly, dealing with tax rate increases on top income earners and entitlement reforms. With just over two weeks remaining before Congress is set to adjourn for the Holiday recess, there is still little indication that either side is ready to compromise.

Failure to reach agreement would trigger major cuts to federal health programs, for example: a 2 percent reduction in Medicare payments would total $11 billion in FY 2013, on top of an estimated 27 percent cut to Medicare physician reimbursements as a result of the Sustainable Growth Rate (SGR).

Sources inform NASS that if a deal cannot be reached soon it is likely that a Congressional conference committee could bring to light the views of party leaders who have shown some willingness to negotiate. During a policy round-table last week, Senate Finance Committee Chair Max Baucus (D-MT) said he was open to using “war savings” as a way to help avert the fiscal cliff. However, provider groups have long advocated for using these savings to permanently fixing the SGR – an idea that is supported by retiring Minority Whip, Senator Jon Kyl (R-AZ).

In light of the on-going negotiations, the Alliance of Specialty Medicine submitted an opinion editorial that ran in Roll Call earlier this week. The editorial reminds Congress of the burden specialty providers face each year as a result of the flawed SGR formula and urges lawmakers to include repealing the SGR in the so-called “fiscal cliff” negotiations.

IRS Releases Medical Device Final Rule

The Internal Revenue Service released its final regulations on the details of the 2.3% excise tax on medical devices levied by the Affordable Care Act. The tax applies to the sale of certain medical devices beginning in 2013. In response to the final rule, 18 Senate Democrats have sent a letter to Senate Majority Leader Harry Reid (D-NV) urging for a delay in implementing a tax on the medical-device industry on the basis that the medical device industry has received little guidance in the way of implementing this provision. The letter’s signers include Senators Richard Durbin (D-IL), Bob Casey (D-PA) and Al Franken (D-MN) and Senator-Elect Elizabeth Warren (D-MA).

A copy of the letter can be found here.

MedPAC Releases Recommendations on Provider Payments

The Medicare Payment Advisory Commission (MedPAC) released the FY 2014 payment rate recommendations under which inpatient and outpatient hospitals would receive a 1 percent increase. The Commission also indicated that it may recommend in January that ambulatory surgical centers be given a 0.5 percent payment increase in FY 2014. The MedPAC recommendations said inpatient rehabilitation facilities, long-term care hospitals and hospice facilities should not receive payment updates in FY 2014. Of particular importance, MedPAC discussed whether to reiterate their previous recommendation to Congress that the sustainable growth rate (SGR) be eliminated in determining future Medicare physician payments.

House Democrats Introduce Second Compounding Bill

On December 5, Democrats Rosa DeLauro (D-CT) and Nita Lowey (D-NY) introduced the second drug compounding bill since the recent meningitis outbreak that has claimed the lives of 37 people and has affected almost 600 nationwide. This new legislation builds upon pieces of an earlier proposal that was introduced by Representative Edward Markey (D-MA).

The bill, Supporting Access to Formulated and Effective (S.A.F.E.) Compounded Drugs Act,” H.R. 6638, would require more wide-spread patient notification requirements, advisory committees, criminal penalties, training for state agencies and guidelines for the production of compounded drugs. Despite the recently introduced bills, sources inform NASS that movement on compounding legislation likely won’t happen until the next Congress. NASS continues to monitor legislation that pertains to the meningitis outbreak.

To access Rep. DeLauro’s press release about this bill, please click here.

In-District Site Visits

On Monday, House Ways & Means Committee Member Representative Richard Neal (D-MA) met with NASS Advocacy Committee Member, Dr. Claude Borowsky, and toured the Pioneer Spine and Sports Physicians Clinic in West Springfield, MA. Representative Neal is arguably favored to become the next Chairman of the Ways & Means Committee should Democrats regain control of the House of Representatives.

During the tour, Dr. Borowsky and other group physicians spoke to Rep. Neal about federal issues that are important to NASS members including: the Sustainable Growth Rate (SGR), the  Independent Payment Advisory Board and Medical Liability Reform. In addition, Dr. Borowsky shared insight into the regulatory issues facing many physicians that provide spine care as a result of the Affordable Care Act.

If you are interested in setting up a site visit at your facility with a Member of Congress, please contact Jordan Abushawish at jabushawish@spine.org