Industry advocates hint new 'threat' in trade bill

Porter warned of a new threat
Porter warned of a new threat

The ink is barely dry on the historic Medicare Access and CHIP Reauthorization Act of 2015 and long-term care and other lobbyists are already voicing concerns about what ominous funding threat might come next.

The new law ended Congress' 17-time habit of kicking the can of Medicare physician rate cuts down the road, and it left a great deal of potential reforms out.

Long-term care and other advocates are now raising a red flag in the wake of last month's historic repeal of the Sustainable Growth Rate, the proverbial “doc fix” that provided a permanent alternative to using fuzzy math to avoid Medicare rate cuts for physicians.

Clifton Porter, senior vice president of government relations for the American Health Care Association, told Bloomberg News this week the act opened providers to a “new threat” that could popularize a practice of using healthcare to pay for non-healthcare legislation. Porter and lobbyists for hospital and physician groups, pointed specifically to the Trade Adjustment Assistance Act. The measure would extend the Medicare sequester through 2024 and increase Medicare cuts by $700 million, according to Congressional Budget Office estimates.

“I hope we didn't trade the resolution of SGR — which was an ongoing, but consistent overhang — for an infinite risk window of less predictable, more problematic” threats, Porter said.

The Medicare sequester allows the ubiquitous budget cuts authorized by the Budget Control Act of 2011 that are tied to deficit reductions.

Physician group lobbyists told Bloomberg they are generally happy, saying the SGR repeal gives much needed stability and allows them broader “bandwidth” to focus on other advocacy issues. Hospital lobbyists told the news service, meanwhile, there's little cause for celebration, calling the law a “stripped down” piece of legislation, “free of extraneous provisions” such as penalties for excess readmissions, audits by Recovery Audit Contractors and a delay of the “two midnight” policy on inpatient hospital stays.

Long-term care industry advocates already are disturbed over the unresolved therapy caps. An amendment to the Medicare Access and CHIP Reauthorization Act of 2015 that would have repealed 9-year-old annual per-beneficiary caps on outpatient therapy services fell short by two votes in the Senate, leading Sen. Benjamin L. Cardin (D-MD) to warn the oversight “would likely cause Medicare beneficiaries to delay necessary care, assume higher out-of-pocket costs, and disrupt the continuum of care for many seniors and individuals with disabilities.”