House Rules Committee Adds Three-Month ‘Doc Fix’ to Budget Deal
On Wednesday, the House Rules Committee added a temporary Medicare "doc fix" to the bipartisan budget deal announced Tuesday by Rep. Paul Ryan (R-Wis.) and Sen. Patty Murray (D-Wash.), The Hill reports (Needham et al., The Hill, 12/11).
According to National Journal, Congress had hoped to permanently eliminate Medicare's sustainable growth rate formula by the end of the year. However, that legislation has been tied up in House and Senate committees and likely will not move beyond markup before the holiday recess (Ritger , National Journal, 12/12).
In a 9-3 vote, the House Rules Committee approved a closed rule to schedule floor consideration of the budget deal and the SGR patch, both as amendments to another measure (HJ Res 59).
If approved, the patch would delay a 24% cut to Medicare physician reimbursement rates -- scheduled to take effect Jan. 1 -- by three months. Instead, the bill would increase current reimbursement rates by 0.5% over three years (Ethridge, CQ Roll Call, 12/11).
According to the Congressional Budget Office, the patch would cost about $8.7 billion (Viebeck, "Healthwatch," The Hill, 12/11). Specifically, the reimbursement increases would cost about $7.3 billion over a decade.
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 (CQ Roll Call, 12/11).
According to Politico Pro, the House is expected to vote Friday on the patch, while the Senate likely will consider it next week as part of the overall budget deal (Haberkorn, Politico Pro, 12/11).
Democrats Threaten Budget Support Over SGR Patch
Several Democratic lawmakers on Wednesday threatened to withdraw their support for the budget deal after the SGR patch was added to the deal but not a continuation of unemployment benefits (The Hill, 12/11).
According to National Journal, Democrats had hoped to extend unemployment insurance payments -- which benefit about 1.3 million U.S. residents and are set to expire on Dec. 28 -- by an additional three months (Ritger , National Journal, 12/11). However, the House Rules Committee on Wednesday rejected such an extension offered by Rep. Sandy Levin (D-Mich.) (The Hill, 12/11).
At the House Rules Committee hearing, Levin said, "The failure to act on [unemployment insurance] and having to do so on [physician reimbursement] puts the entire bill at risk ... It's not a cut of 25% -- it's 100% elimination of their benefits. It's historically high" (Ritger , National Journal, 12/11).
Separately, House Democratic Minority Leader Nancy Pelosi (D-Calif.) said, "It's absolutely unconscionable that we are -- could possibly even consider leaving Washington, D.C., without extending those benefits" (Lawder/Ferraro, Reuters, 12/11).
Sen. Debbie Stabenow Aims To Attach Mental Health Bill to SGR Fix
In related news, Sen. Debbi Stabenow (D-Mich.) plans to attach a proposal that would create a demonstration project for community mental health care to the SGR fix when the Senate Finance Committee marks up the legislation on Thursday, CQ Roll Call reports.
The proposal would establish a demonstration project of a mental health bill (S 264) that Stabenow proposed with Sen. Roy Blunt (R-Mo.). The project aims to qualify and reimburse mental health services under Medicaid in 10 participating states in the same way that federally qualified community health services receive reimbursement for primary care services. It also aims to increase coordination among community mental health providers and other health care providers, such as Veterans Affairs clinics.
Debate on the broader bill stalled earlier this year, according to CQ Roll Call (Attias, CQ Roll Call, 12/11).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.