Numerous Medicare funding 'extenders' at risk for expiration

While long-term care professionals have at least two more weeks to agonize over the fate of a bill that would permanently repeal the current Medicare physicians funding formula, a host of other key funding “extenders” set to expire also hang in the balance.

The Senate left for recess on Friday without acting on HR 2, which the House overwhelmingly approved the day before. The bill would permanently repeal the sustainable growth rate formula that has consistently required a funding “patch” to stave off Medicare rate cuts for physicians. A mid-April vote is now being eyed, according to published reports.

In its March 25 report, the Congressional Research Service reports that among the 15 Medicare “extenders” at risk are a statute that suspends a $1,500 limit on outpatient physical therapy services and assistance for rural ambulance providers in low population density areas. Other extenders at risk provide block grants to states for social services and elder justice, health professions opportunity grants for low-income individuals, and the Children's Health Insurance Program. Many are part of the Protecting Access to Medicare Act of 2014 (PAMA).

The law also would provide funding for certain Medicaid extenders, including the qualifying individual program, payments to primary care providers, transitional medical assistance, a Medicaid and CHIP “Express Lane” option, improving access to clinical trials and the balancing incentive payments program.