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Tag Archive | "Physician Payment"

MedPAC Releases June 2011 Report to Congress

The Medicare Payment Advisory Commission (MedPAC) released its June 2011 Report to Congress. The report includes recommendations on two areas: (1) improving payment accuracy and appropriate use of ancillary services; and (2) enhancing Medicare’s technical assistance to and oversight of providers. To improve technical assistance of oversight of Medicare providers, MedPAC’s recommendations focus on the restructuring of Medicare’s Quality Improvement Organization (QIO) program.

Specifically, MedPAC makes the following recommendations:

  • Congress should resign the QIO program to allow the Department of Health and Human Services (HHS) Secretary to provide funding for technical assistance directly to providers and communities.
  • Congress should authorize the HHS Secretary to define criteria to qualify technical assistance agents so that a variety of entities can compete to assist providers. The Commission recommends that Congress eliminate the requirements that agents be physician sponsored, serve a specific state, and have regulatory responsibilities.
  • The HHS Secretary should make low performing providers a high priority in allocating resources for technical assistance for quality improvement.
  • The HHS Secretary should regularly update the conditions of participation so that the requirements incorporate and emphasize evidence-based methods of improving quality of care. Congress should require the Secretary to expand interventions that promote systemic remediation of quality problems for persistently low-performing providers.
  • The HHS Secretary should establish a public recognition program for high performing providers that work to improve the quality of lower performing providers.

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Capital Thinking Podcast

The historic snowfall may have shut down the federal government for four days, but the Senate remained focused on advancing a jobs bill. In a surprise move, Senate Majority Leader Reid announced that the Baucus-Grassley jobs/extender bill, the “Hiring Incentives to Restore Employment” (HIRE) Act, which included several health-related provisions, will not be considered by the Senate. Instead, Sen. Reid plans to advance a smaller bill that does not include health-related provisions. The scaled-down bill now consists of payroll tax relief for businesses that hire new workers, extensions of the Highway Trust Fund and the “Build America” bond program, and expense deductions for small businesses. His announcement was apparently prompted by partisan tensions and disagreements on policy within the Democratic caucus.

The HIRE ACT contained a three-month extension of COBRA health benefits and a physician payment “fix” to prevent a 21 percent cut in Medicare payments on March 1. The health-related provisions may be advanced as a separate measure once Congress returns from its President’s Day recess.

Additionally, after the recess, President Obama will host a bipartisan commission health care summit with congressional leaders that will be televised live on February 25th. Health and Human Services Secretary Kathleen Sebelius and White House Chief of Staff Rahm Emanuel sent a letter to Republican and Democratic congressional leaders formally inviting them to the summit and informed them that the President intends to bring his own health reform proposal to discuss. Until now, the Administration has been hands off in drafting specific legislative language, and has left that role almost entirely to Congress. The letter stated that the legislation will “put a stop to insurance company abuses, extend coverage to millions of Americans, get control of skyrocketing premiums and out-of-pocket costs, and reduce the deficit.” Republicans were also encouraged to put forward their own health reform legislation for consideration at the summit.

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Capital Thinking Podcast

In the President’s State of the Union Address, he did not lay out a path to passing health care reform and as the days pass, Democratic Leadership has yet to determine the best way, or even whether to, move comprehensive reform. Despite House Speaker Nancy’s Pelosi’s earlier declaration that she does not have the votes to pass the Senate reform bill, Senate Majority Leader Reid has signaled that the option remains alive. Specifically, the House could pass the Senate bill along with changes to the legislation in a reconciliation bill that would only require 51 votes in the Senate for passage. We expect the trajectory of health care reform legislation to become more apparent prior to the week-long President’s Day recess.

Last week, the Senate passed a resolution to increase the debt ceiling, which creates a path for potential consideration of a five-year Medicare physician payment fix that would be exempt from the pay-go rules. Congressional action is necessary to prevent a 21 percent Medicare physician payment cut from going into effect on March 1, 2010.

The Centers for Medicare and Medicaid Services released an interim final rule, which implements the Wellstone-Domenici Act, requiring that any group health plan that offers both mental health and substance abuse benefits along with standard medical coverage must treat them equally – same out-of-pocket costs, benefit limits and practices. The regulation is effective for plan years beginning on or after July 1, 2010.

Today, President Obama will release his Fiscal Year 2011 budget.  In his State of the Union Address, the President announced that discretionary government spending will be frozen for three years. In June 2009, the Office of Management and Budget Director Peter Orzsag provided directed agencies to freeze FY 2011 discretionary funding at FY 2010 levels or reduce spending by 5 percent.  According to the OMB memorandum, the President’s budget goals are to “encourage economic growth, invest in the future, and responsibly govern the Nation.” Executive Departments and their agencies are hosting budget briefings early in the week and a number of Cabinet officials are scheduled to testify before Congress at budget hearings.

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