Senate passes 'doc fix' bill that links skilled nursing facility payments to hospital readmissions, delays ICD-10

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Senate Majority Leader Harry Reid (D-NV)
Senate Majority Leader Harry Reid (D-NV)

Both houses of Congress now have passed legislation to tie skilled nursing facility Medicare reimbursements to hospital readmissions, starting in 2018. The Senate approved the  “Protecting Access to Medicare Act of 2014” in a 64 to 35 vote Monday evening.

The measure, which also would postpone the transition to the ICD-10 code set by one year and prevent scheduled physician pay cuts, was expected to be swiftly signed by President Barack Obama. The 24% hit to doctor pay, called for under the Sustainable Growth Rate system, was scheduled to take effect today unless a “patch” was enacted.

Prominent long-term care provider associations LeadingAge and the American Health Care Association/National Center for Assisted Living supported the bill. AHCA/NCAL President and CEO Mark Parkinson sent a letter to Senate Majority Leader Harry Reid (D-NV) prior to the vote on Monday, urging passage but emphasizing the need for a permanent repeal of the SGR.

Long-term care providers frequently have seen their reimbursements reduced to help offset the costs of constantly postponing doctors' payment cuts, Parkinson noted. Under the “Protecting Access” bill, SNFs would not experience an across-the-board cut to help pay for the one-year “doc fix.” However, they would have 2% of their Medicare reimbursements withheld upfront starting in October 2018; 70% of this money then would be distributed to providers that improve their rate of hospital readmissions.

AHCA/NCAL was an important architect of this plan, which is designed to save Medicare money while improving healthcare outcomes. In his letter, Parkinson expressed hope that this “contribution” is remembered as Congress weighs future policy — an appeal to prevent long-term care cuts to help pay for a permanent SGR repeal that has been floated by the Senate Finance Committee.

The Senate vote came after the bill passed the House in a controversial voice vote Thursday.

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