The Obama administration has begun the process of
shifting control over Medicare rate adjustments for nursing homes, hospice and
other providers away from Congress and toward a new, five-member independent
executive agency, according to recent reports.
According to draft legislation being written by the White
House, the proposed agency, the Independent Medicare Advisory Council, would
comprise five president appointed, congressionally approved members, usually
physicians or others with special medical expertise, reports Politico.com. The
agency's primary role would be to set payment rates for Medicare Part A and
Part B, which it would do through issuance of two annual reports. Congress
could choose to block these proposals within 30 days, and the president would
retain an up-or-down veto power over the agency, according to Politico.
The Medicare Payment Advisory Commission currently acts
only as an advisory body to congress. In its most recent suggestion to
congress, MedPAC recommended freezing rates for skilled nursing facilities and
cutting reimbursements to home health agencies by 5.5% (McKnight's, 1/12). By
giving a new commission authority to implement the changes it recommends, the
White House could potentially damage the financial stability of SNFs and other
long-term care agencies, long-term care provider advocates say.
For more on this topic, see our May 29 issue of The
Editors' Blog.