House Approves Bipartisan Budget Deal That Includes ‘Doc Fix’
The House on Thursday voted 332-94 to approve a bipartisan budget deal that includes a short-term Medicare "doc fix," the Los Angeles Times reports (Mascaro, Los Angeles Times, 12/12).
The budget deal -- negotiated by House Budget Committee Chair Paul Ryan (R-Wis.) and Senate Budget Committee Chair Patty Murray (D-Wash.) -- would increase discretionary spending by $63 billion. The increase would be divided evenly between military and domestic spending, including eliminating cuts to health research.
Overall, the deal would generate total savings of $85 billion and reduce the federal deficit by $23 billion. Savings would come in part by extending the sequester's 2% cut to Medicare reimbursements through 2023, two years beyond the cuts set by the Budget Control Act of 2011. It would not alter Medicare benefits (California Healthline, 12/11).
On Wednesday, the House Rules Committee voted 9-3 to add an amendment to the deal that would delay for three months a 24% cut to Medicare physician reimbursement rates -- called for by the sustainable growth rate formula and scheduled to take effect Jan. 1 -- and increase current reimbursement rates by 0.5% over three years. According to the Congressional Budget Office, the patch would cost about $8.7 billion over a decade, about $7.3 billion of which would come from the half-percentage-point payment increase.
However, the patch also contains several offsets, which means it actually would result in $300 million in overall savings over 10 years. Those offsets include:
- Altering the extension of the 2% cut Medicare providers see under sequestration so that the reduction would be 2.9% in the first six months and 1.1% in the last six months;
- Delaying Medicaid cuts to disproportionate-share hospitals to fiscal year 2016, while increasing the cuts at that time from $600 million to $1.2 billion and extending cuts for another year through FY 2023; and
- Changing payments for inpatient services in long-term care hospitals so that patients who stay longer than three days in an intensive care unit or who are on a ventilator receive a higher payment rate and all others receive reimbursements at a lower, inpatient-facility rate.
In addition, the patch extends several other payment provisions on Medicare and other health programs that would otherwise expire, including a three-month extension on Medicare's caps for therapy services and additional ambulance services (California Healthline, 12/12).
Despite some initial concerns by Democrats over the lack of an extension to unemployment benefits, the bill passed, with support from 169 Republicans and 163 Democrats. Sixty-two Republicans and 32 Democrats voted against the bill (Hook, Wall Street Journal, 12/13).
The measure now goes to the Senate, which is expected to pass it next week. Congress will need to grant final approval to the bill soon to avoid a federal shutdown on Jan. 15 (Los Angeles Times, 12/12).
AHA Criticizes Budget Deal
The proposal drew criticism from the American Hospital Association for extending the Medicare reimbursement cuts, The Hill's "Healthwatch" reports.
In a statement, AHA Senior Vice President Tom Nickels said, "Hospitals face a huge array of change and challenges." He added, "From electronic health records to new penalty programs and payment models to new regulatory hurdles, Congress should support these efforts rather than add uncertainty" (Viebeck, "Healthwatch," The Hill, 12/12).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.