White House and Senate to OK House short-term Debt-Ceiling Bill

The White House and Democratic Senate leaders signaled last week their support to help pass legislation that temporarily removes the threat of the country defaulting on capitol webits debt. As reported last week, the House passed a short-term measure, H.R. 325, which delays the nation hitting its debt-limit until mid-May. The White House said it was encouraged to see cooperation among House GOP members for devising this plan and averting another stale-mate in Congress over budget matters.

However, delaying the nation’s debt-ceiling will likely exacerbate the on-going budget battles in the coming months, as lawmakers will have to grapple with looming cuts to Medicare providers and funding the federal government through the remainder of FY 2013. In October 2012, Congress passed a six-month Continuing Resolution to fund the government that expires in March 2013, the same month that the sequestration is set to take effect.  Unless Congress acts quickly, providers will face up to a 2 percent reduction in Medicare reimbursements. House Budget Committee Chairman Paul Ryan (R-WI) said last week he believed that it was unlikely that Congress could come together to agree on a plan to avert the sequestration by the March deadline.

In the meantime, newly appointed Senate Budget Committee Chairwoman, Senator Patty Murray (D-WA) indicated last week that she plans to move a budget resolution for FY 2014 through her Committee and for consideration by the full Senate in March. Murray’s statement is in response to the stipulation within H.R. 325 which requires the Senate to pass a budget in April or lose its pay until it’s able to do so.

A copy of H.R. 325 can be found here.

Plan by House Republicans to Balance Budget in 10 Years Raises Concerns for Medicare Providers

Last week, House Republicans touted a plan that they say will balance the budget in 10 years by cutting health care costs to entitlement programs such as Medicare and Medicaid. Speaker of the House, John Boehner (R-OH), reportedly informed the House Republican Caucus last week that he would push for legislation this year to balance the budget if his party voted in favor of a short-term measure to raise the debt-ceiling.

While details are scare, insiders say this move will further complicate efforts to replace the faulty Medicare Physician Payment formula. According to the Congressional Budget Office (CBO), the deficit over the next 10 years will reach $2.2 trillion dollars, and House Republicans would need to come up with at least $2 trillion in cuts to entitlement over that same period to balance the budget. While the Administration and Senate Democrats have signaled its intention to work with House Republicans in balancing the budget, it’s unlikely that they can agree to such cuts to entitlement programs without major revenue increases. NASS and the Alliance of Specialty Medicine will be meeting with Congressional Staff from the Senate Finance, House Energy and Commerce, and House Ways and Means Committees to discuss the threat of Medicare cuts to providers and as well as the SGR.

House Energy and Commerce Committee to Hold Hearing on SGR

NASS has been informed that the House Energy and Commerce Sub-Health Committee is tentatively planning to hold a hearing on the Sustainable Growth Rate (SGR). This report comes as NASS and others continue to pressure lawmakers to identify new mechanisms through Medicare to pay doctors after Congress passed a one-year extension earlier this year. As reported last week, Rep. Kevin Brady (R-TX) has been appointed to chair this subcommittee, replacing Wally Herger (R-CA). Rep. Brady said that replacing the SGR will be his top priority and said he was hopeful that his committee would introduce legislation this year.

IPAB Repeal Legislation Introduced in House of Representatives

Last week, a bi-partisan duo in the House of Representatives introduced legislation that would repeal the Affordable Care Act’s (ACA) Independent Payment Advisory Board (IPAB). Rep.’s Phil Roe, MD (R-TN) and Allyson Schwartz (D-PA) co-sponsored H.R. 351, Protecting Seniors’ Access to Medicare Act, which seeks to eliminate the panel that is tasked with identifying areas to reduce Medicare spending. Starting in 2014, if the Medicare spending is higher than targeted rates, the IPAB will set payment policies for Medicare unless Congress comes up with its own plan to reduce spending.

Other co-sponsors of this legislation include: Rep.’s Phil Gingrey (R-GA), H. Morgan Griffith (R-VA), Marsha Blackburn (R-TN), Tom Price, MD (R-GA), Bill Johnson (R-OH), Tim Huelskamp (R-KS), and Joe Courtney (D-CT). Along with the Alliance of Specialty Medicine, NASS strongly opposes the IPAB and will be sending a letter of support for this legislation in the coming days.

A copy of this legislation can be found here.

Provider Incentive Payments at Risk Due to Faulty EHR’s

A report released by Cornell Medical College last week finds that some quality measures reported via electronic medical records (EHR’s) may not be as accurate as reporting measures by manual review. The study comes at a time when many providers continue to raise concerns about the effectiveness of EHR programs and whether the reports accurately reflect the quality of care that is given to patients. The study also found that EHR’s have a tendency to overstate and understate quality reporting, which could affect the financial incentive that is gained for providers participating in the program. In 2014, providers will be required to successfully participate in certified EHR technologies for 90 days. The report cited that variance in measures are a result of the automated systems inability to read physicians notes within their reports.