SGR Talks Sidelined for Now While Congress Works on FY-2014 Funding Bill

Since returning to Washington from its winter recess, members of the House and Senate capitol webAppropriations committees have been hammering out the detail of a Fiscal Year 2014 funding package. Under the agreement that was reached shortly after last year’s government shut down, top budget and appropriations lawmakers had until Jan. 15, 2014 to come up with an agreement to fund government agencies for 2014. While that deadline has passed, Congress is expected to pass a temporary three-day extension of the current funding levels, which will hopefully give both chambers enough time to pass the $1.1 trillion omnibus package for 2014 on Saturday.

Among other things, the funding bill contains no new funding for ACA reduces funding for the Independent Payment Advisory Board (IPAB) by $10 million. A list of the major health related funding provisions can be found here.

House Ways and Means and Energy and Commerce committee negotiators are expected to continue their work on merging two sustainable growth rate (SGR) replacement bills that were passed out of each committee last year. At this time it’s unclear how Senator Max Baucus’ (D-MT) ambassadorial appointment will affect the SGR repeal timetable in that chamber. In recent interviews, Chairman Baucus has stated that he expects to see replacing the SGR through to the end, despite several rumors that his appointment could come as early as this March. And while the short-term, three-month SGR patch was intended to give Congressional leaders enough time to hash out differences between the top three replacement bills, the issue of pay-fors could delay that timeline.

Rumors have been circulating that Democrats are rehashing previous demands that Overseas Contingency Operations (OCO) funds should be used to pay for the cost of repealing the SGR. However, in recent interviews, House Republicans in the Doctors Caucus shot down any expectations that it their party would support the use of OCO funding for these purposes.

NASS and the Alliance of Specialty Medicine will be conducting high-level meetings on Capitol Hill in the coming weeks with leaders in the House and Senate to express joint concerns contained within each chambers SGR bills. More information on timelines and potential policy changes will be forthcoming.

HHS to End RAC Appeals Until Backlog Clears

Last month, the Department of Health and Human Services (HHS) informed certain hospitals with high-levels of appeals claims that it would not review the newer cases until all previous appeals claims are reviewed. Hospitals argue that it would take more than two years for new appeals to be taken up by the agency appeals division. For more information, click here.

CMS to Reveal Medicare Payments to Physicians

The Centers for Medicare and Medicaid Services announced today that the “Department has decided to replace the prior policy, as set forth in the November 28, 1980 Federal Register (45 FR 79172), with a new policy in which CMS will make case-by-case determinations as to whether exemption six of the Freedom of Information Act applies to a given request for information pertaining to the amounts that were paid to individual physicians under Medicare.” The announcement comes after a recent court decision in Florida that found that physicians’ privacy was outweighed by the public interest. For more information, please click here. The CMS notice can be found here.