HOUSE TO VOTE ON SGR BILL CONTAINING ACA OFFSETS: As it has been widely reported, Republican leadership has indicated that the House of Representatives capitol webwill vote on a sustainable growth rate (SGR) replacement bill later this week that will contain offsets by delaying for several years, the Affordable Care Act’s individual mandate. Unfortunately, a bill containing offsets provided by a core tenet of the ACA will all but certainly be refuted by Congressional Democrats and the Administration. It’s believed that the House proposal to delay the individual mandate will free up the subsidies that the federal government would have given to low-income purchasers of health insurance through the ACA exchanges. NASS will be submitting a letter of support for the SGR legislation, however, will also highlight NASS’ concerns over using partisan offsets for the bill. NASS will be keeping a very close watch on any developments and provide updates as they become available.

DOC CAUCUS WEIGHS IN ON PENDING SGR VOTE: The House Republican Doctors Caucus sent a “dear colleague” letter to their House counterparts today expressing slight dismay over the use of ACA funding to pay for the SGR bill. However, caucus members are still encouraging House members to vote affirmatively on the bill to keep the process moving forward.

ANTI-TRUST LEGISLATION RE-INTRODUCED IN HOUSE: On February 25th, Congressman John Conyers, Jr. (D-MI) and Congressman Dan Benishek, M.D. (R-MI) introduced H.R. 4077, the “Quality Health Care Coalition Act of 2014.” According to Rep. Conyers, this legislation allows for physicians to negotiate with insurers on a level playing field, ensuring heightened quality standards for patient care. NASS has supported previous iterations of this legislation and is reviewing the current proposal for support.

CMS ADMINISTRATOR SENDS LETTER TO CONGRESS ON CONTROVERSIAL RULE:Yesterday the Centers for Medicare and Medicaid Services (CMS) Administrator, Marilyn Tavenner, sent a letter to Congress on the proposed CY 2015 Medicare Advantage and Part D rule .  In the letter, CMS  announced that it will not move forward with four of the proposed provisions, including the issue related to the protected classes. It will, however, move forward with the issues that impact physicians ie, enrollment requirements and criteria for improper prescribing practices. NASS raised several of these concerns with the rule in comments that were submitted to CMS last week. As for next steps, NASS will be  reviewing its options to address CMS’ latest decision. More information will be forthcoming.

SENATORS QUESTION CMS MEANINGFUL USE EXEMPTION RULE: Senators Lamar Alexander (R-TN), John Thune (R-SD) and several other Republicans sent a letter to the Centers for Medicare and Medicaid Services (CMS) Administrator expressing their disappointment that CMS has not allowed providers an extension of the reporting period for Stage 2 of the Meaningful Use (MU) program. They questioned how the proposed “hardship” exemptions from the rule will be applied so as to offer at least some relief.

PRESIDENT RELEASES FY 2015 BUDGET: The first stage of President Obama’s Fiscal Year 2015 Budget was released on Tuesday, March 4, 2014. In total, the Obama Administration’s budget proposes $3.9 trillion in outlays for fiscal year FY 2015, a $250 billion increase over the $3.6 trillion estimated for FY 2014. For the Department of Health and Human Services (HHS), the budget assumes $77.1 billion in base discretionary resources, which is $0.8 billion below the 2014 enacted level. Key health related proposals in the budget include:

  • lowering the target rate applicable for 2018 and beyond to trigger the independent payment advisory board (IPAB);
  • $14.6 billion over 10 years to improve and expand the health care workforce;
  • 0% update to Medicare physician reimbursements, given the overall cost of $110 billion built into the budget; and
  • Prohibition of certain referrals for radiation therapy, therapy services, advanced imaging, and anatomic pathology services except in cases where a practice meets certain accountability standards, as defined by the Secretary.

As of late, the president’s budget has been treated as an annual ritual and bears little influence as to the final outcome of federal budgeting and appropriations. However, the document is intended to send a powerful political statement regarding President Obama’s funding priorities in the spheres of federal spending. More about the president’s FY 2015 budget can be found here.