Friday, January 31, 2014

Updated: SGR status still in limbo

Drew Thies



Despite optimism from some on the Hill, many think that the chances of repealing and replacing the Medicare physician payment schedule this year are uncertain. Lawmakers have until March 31 to pass a policy that either extends the current law or replaces it.

A temporary patch to the sustainable growth rate (SGR) known as a “doc fix” has become an annual ritual for Congressional health staffers, but those on the House Ways & Means and Energy & Commerce Committees as well as their counterparts on the Senate Finance Committee are hoping to do away with that in 2014. Each committee has a different bill to reform the SGR, all of which they are working to reconcile into a single piece of legislation.

Senate Finance Chairman Max Baucus (D-MT) said last week that all committees are “working very hard on it.” According to the statement, he had hopes to wrap up official policy negotiations by the week’s close, but committees continue mull over specifics.

Baucus recently announced he will take an early retirement from the Senate to become the next U.S. ambassador to China. That shift is expected to take place in the coming weeks, adding another deadline affecting the negotiations.

Others are not as optimistic. Rep. Charles Boustany (R-LA) said progress in talks over merging the three bills “seemingly has stalled.”  

The March 31 deadline does not leave legislators and their aides with much time for finalizing a bill. “We’re running out of time,” Boustany said. “We may end up with another one-year patch before it’s all over.”

One of the major points of contention is where the repeal effort would receive its funding. The Congressional Budget Office (CBO) found that the Ways & Means version would cost $121 billion over ten years while the Energy & Commerce and Senate Finance versions are in the $150 billion range.

The Senate Finance Committee recently released a laundry list of dozens of potential offsets that could pay for a final version of the bill. Many would undoubtedly upset the affected provider groups and Senate Finance aides attached the disclaimer “not necessarily endorsed by SFC Staff” to the list.

AHCA’s legislative office continues to monitor the development to see if a final version of SGR reform comes to the fore and to reinforce the importance of the long term care community when legislators begin to mull offsets.

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