MEDPAC backs pay hike

Pro­posal would re­store cuts in spend­ing deal

Modern Healthcare - - LATE NEWS - Rich Daly

The panel that pro­vides Congress with Medi­care guid­ance sought to shield providers from loom­ing pay­ment cuts. In its first meet­ing of the year, the Medi­care Pay­ment Ad­vi­sory Com­mis­sion ap­proved a se­ries of rate rec­om­men­da­tions for the fis­cal year that starts Oct. 1 that it wants Congress to stick to, re­gard­less of the 2% across-the-board cut to Medi­care pay­ments un­der the se­ques­tra­tion process of the 2011 Bud­get Con­trol Act.

Law­mak­ers post­poned that cut in the yearend fis­cal deal, but it’s sched­uled to be­gin March 1 for all Medi­care providers un­less Congress again acts to avert it.

In the case of in­pa­tient and out­pa­tient hospi­tal ser­vices, the panel urged Congress to pre­vent HHS Sec­re­tary Kath­leen Se­be­lius from im­ple­ment­ing more than a small amount of an ad­di­tional cut in­cluded in the fis­cal agree­ment.

Un­der the Amer­i­can Tax­payer Re­lief Act of 2012, Se­be­lius is re­quired to find an­other $11 bil­lion in sav­ings from hos­pi­tals within four years through rate re­duc­tions. If the cut was evenly spread out over the four years— as the Con­gres­sional Bud­get Of­fice as­sumed it would be—then it would re­duce the fis­cal 2014 up­date to a 0.6% cut.

In­stead, MedPAC urged a 1% in­crease for hos­pi­tals’ in­pa­tient and out­pa­tient prospec­tive pay­ments. That fig­ure is tech­ni­cally a re­duc­tion, ac­cord­ing to Medi­care’s com­plex ac­count­ing rules, be­cause un­der a pre-ex­ist­ing leg­isla­tive for­mula, hos­pi­tals should re­ceive a 1.8% in­crease in Oc­to­ber. But if the MedPAC rec­om­men­da­tion is fol­lowed, Medi­care hospi­tal spend­ing would in­crease in the next fis­cal year by up to $2 bil­lion, ac­cord­ing to the ad­vi­sory body.

“The con­text has changed since our De­cem­ber dis­cus­sion; a pro­posal that would have saved money rel­a­tive to the cur­rent law base­line in De­cem­ber now costs money rela- tive to the new base­line as amended by the Tax­payer Re­lief Act,” said Glenn Hack­barth, chair­man of MedPAC. “The fact that the leg­isla­tive con­text has changed does not al­ter our con­clu­sion that the base rate should in­crease by 1%, re­gard­less of the Tax­payer Re­lief Act, re­gard­less of se­ques­tra­tion that may hap­pen in the fu­ture.”

The rec­om­men­da­tion drew im­me­di­ate praise from the Amer­i­can Hospi­tal As­so­ci­a­tion. Chan­tal Worzala, di­rec­tor of pol­icy at the AHA, said the group also con­tin­ues to dis­pute that cod­ing-re­lated re­duc­tions are needed to re­cover over­com­pen­sa­tion.

Sim­i­larly, MedPAC urged Congress to keep pay rates un­changed for in­pa­tient re­ha­bil­i­ta­tion fa­cil­ity ser­vices, home health ser­vices, out­pa­tient dial­y­sis ser­vices, long-term-care hospi­tal ser­vices and hospices next fis­cal year, even if the se­quester cut goes into ef­fect.

MedPAC also rec­om­mended that Medi­care rates for am­bu­la­tory surgery cen­ters re­main un­changed, de­vi­at­ing from the 0.5% in­crease that Hack­barth rec­om­mended in De­cem­ber. MedPAC mem­bers re­jected in­creas­ing surgery cen­ters’ rates, in­stead bas­ing the rate rec­om­men­da­tion on its stan­dard mea­sures of in­dus­try­wide sup­ply and de­mand as part of an at­tempt to close the re­im­burse­ment gap be­tween ASCs and sim­i­lar hospi­tal set­tings.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.