Skilled nursing providers and inpatient rehab facilities offer clashing views on Medicare payments

Certain long-term care providers would get a temporary break on Affordable Care Act requirements regarding employee insurance plans under a bill introduced in the House of Representatives.

The ACA’s “employer mandate” calls for businesses with a certain number of full-time workers to provide affordable health plans to employees or face penalties. The “Ensuring Medicaid and Medicare Access to Providers Act” would exempt eligible organizations from those requirements for two years, according to information released Wednesday by the office of Rep. Steve Daines (R-MT). Daines initially introduced the bill on July 14.

Government health plans reimburse at a lower rate than private plans do for comparable services, so providers that primarily serve Medicare and Medicaid beneficiaries are under extra financial pressures, Daines noted. For these providers, the “oppressive” employer mandate could lead to job cuts and reduced hours or wages, compromising care for seniors and others on Medicare and Medicaid, he said.

The employer mandate exemption would apply to providers that meet certain criteria, such as  Medicare and Medicaid payments that equal or exceed 60% of total receipts during particular timeframes, according to the bill text. Daines singled out home health agencies as particularly vulnerable in his remarks before the House.

The employer mandate originally was scheduled to take effect this year but was delayed until Jan. 1, 2015.