Fiscal Cliff: A Summary of Relevant Provisions
Congress averted an approximate 30 percent reduction in Medicare reimbursement through the passage of H.R. 8, the American Taxpayer Relief Act. This bill is also known as the Middle Class Tax Relief Act. President Barack Obama stated his intent to sign H.R. 8.
The following health provisions were included in H.R. 8:
- Extends current Medicare physician payment rates through Dec., 31, 2013, thus avoiding the 26 percent sustainable growth rate (SGR) reduction;
- Extends the Geographic Work Adjustment through Dec 31, 2013;
- Defers sequestration cuts for two months (a 2 percent reduction in Medicare payments and larger program cuts for other health programs such as medical education and public health research);
- Includes provisions to improve the delivery of relevant and timely data to physicians needed in new delivery and payment models;
- Allows physician participation in clinical data registries to meet Medicare quality reporting requirements; and
- Provides one year reauthorization of funding for National Quality Forum.
The $25 billion cost for the SGR patch and additional expenses for other Medicare extender provisions were offset with an array of provisions. ASNC is pleased that proposals to restrict the use of in-office ancillary services were not included. However, payments for advanced imaging services will be reduced based on a change in assumptions regarding the utilization of equipment (effective in 2014). Other offsets included extending the statute of limitations from three to five years for recoupment of overpayments and rebasing Medicaid Disproportionate Share Hospital payments for an additional year.
The SGR and sequestration cuts to physician reimbursement would have been devastating for physician practices and patient access. While ASNC is pleased that these reductions have been averted, it is important to note that these legislative fixes are merely temporary. The legislation delays sequestration by two months and provides a one-year patch to the SGR. ASNC will continue to press Congress to reach a permanent solution and provide stable reimbursement.