Congress Passes Bill to Delay Medicare Reimbursement Cuts

On Monday evening the Senate passed and President Obama signed the Protecting Access to Medicare Act of 2014 (H.R. 4302) into law. This marks the 17th time Congress delayed the cuts to physician reimbursements established with the Sustainable Growth Rate under Medicare. The bill delays a 24% cut to the payments.

The Senate passed the bill with a 64-35 vote the evening the cuts were to go into effect at midnight. The Senate vote was preceded by the House passing the bill with a rare voice vote last week.  Both chambers moved quickly to pass this bill after it became obvious no agreement would be reached on how to pay for the permanent 'doc fix' bills.  

The Sustainable Growth Grate (SGR) was created in 1997 by Congress as a mechanism for tracking the payments with economic growth. The SGR became a problem within a few years as increases in healthcare costs substantially outpaced economic growth. This development resulted in the creation of a multi-billion dollar shortfall for the funding of Medicare payments to physicians. 

Members on both sides of the aisle and in both Chambers spoke about the need to permanently fix the SGR. However, they recognized the immediate need to prevent the delay's expiration and prioritized this temporary patch over a lengthy negotiation process to pass a  permanent fix that would result in the expiration of the SGR delay. 

Bill to Delay ICD-10 and Sustainable Growth Rate Patch Passes House

Advocates on behalf of hospitals and practitioners were optimistic about the likelihood of a permanent 'fix' to the Sustainable Growth Rate for Medicare's physician reimbursement system. Members in both the House and the Senate introduced bills this session that would repeal the Sustainable Growth Rate in Medicare's physician payment formula. 

In a surprise development today the House passed the Protecting Access to Medicare Act of 2014, H.R. 4302, by voice vote. This bill does not provide a permanent fix, only a one year patch to the Sustainable Growth Rate. The legislation, sponsored by Rep. Pitts of Pennsylvania, did not extend a fix for the SGR to physician-owned hospitals. Insiders agree that the cost of longer term bipartisan bills with permanent fixes to SGR were tabled because the parties were not able to agree on how to pay for the costs--about $140 billion over a 10 year period.  

Many on the hill expect the Senate to move this bill to a vote tonight. Speaker Harry Reid is said to be working on a deal to bring the bill to the floor. However, Senator Wyden is said to be pushing back on passing a bill with only a short term fix. Stakeholders following SGR legislation believe that if a temporary fix is passed the Congress will feel less pressure, and efforts to pass a permanent fix this year will fade into the background. 

The Protecting Access to Medicare Act of 2014 also contains a provision to delay the ICD-10 meaningful use requirements until October 2015. CMS Administrator Marilyn Tavenner has repeatedly stated that the agency was not going to extend the ICD-10 meaningful use requirements. Many eligible practitioners and hospitals are concerned about being able to meet the deadline and have publicly appealed to the agency and Congress to extend the compliance deadline.