SNF bad debt provision could be included in 'doc fix' agreement, lobbyists warn

House may address stimulus package this week

Lawmakers are close to reaching a deal to prevent a 27% cut in Medicare payments to physicians for the remainder of 2012.

House and Senate leaders brokered the deal, known as the “doc fix." It would be paid for by reducing federal healthcare spending by approximately $21.1 billion, according to a report from The Hill.

That would include a $6.8 billion reduction in federal payments to hospitals and skilled nursing facilities that collect bad debt, a proposal that left nursing home industry lobbyists chafing.

American Health Care Association Vice President of Public Affairs Greg Crist said that it was unclear at press time how much of the burden SNFs would be asked to shoulder under this provision. But SNFs would be hard-pressed to collect bad debt from residents are dually eligible for Medicare and Medicaid, and thus don't have the ability to pay, Crist explained.

“Our point is, it's not really fair to go out and ask SNFs, through bad debt, to pay a disproportionate share of this measure, particularly as this relates to states,” Crist told McKnight's. He added that states such as Florida would be unfairly burdened.

The doc fix is part of the payroll tax extension deal, which also includes provisions for the extension of unemployment benefits. A final deal could come for a vote in the House and Senate as soon as the end of this week.