Leaders of the nation’s two largest long-term care associations spoke favorably Monday about a bill that would improve Medicare physician pay rates while moderately restricting LTC pay. In fact, the head the American Health Care Association said the group will “enthusiastically support” a bill that would end the “doc fix” issue, provided the final language is what it expects.
The conditions for the support of AHCA/NCAL are that Congress agrees there will be no more additional cuts to the industry; that there will be “therapy review language” to alleviate manual medical review claims; and “no surprises,” President and CEO Mark Parkinson said Monday. Assuming the bill is as expected, AHCA plans to enlist its members to petition lawmakers for their support.
The bipartisan deal would repeal Medicare’s sustainable growth rate for doctors. Early negotiations around the cuts means long-term care would have a hard-wired 1% increase in fiscal year 2018. This would keep physician reimbursement rates stable for at least a decade, but cut around $30 billion from other providers to pay for the measure. While providers would be hit, the bill offers a practical way forward, Parkinson said.
“The easy pay-fors or pay-fors that are low-hanging fruit” were tackled long ago, he said in a call Monday with reporters, and the prospect of future, worse doc fixes “puts a cloud over the whole sector.”
Physicians face a 21.2% cut in Medicare reimbursements if Congress does nothing by March 30, when the current legislation expires.
Parkinson said he “wouldn’t be surprised if other provider groups take a different position.”
“I would understand support or opposition to this proposal,” he said. “The 2018 cut is hard. But if this falls apart and it’s a series of one-year doc fixes, all of those doc fixes would be paid for with provider cuts.”
In an about-face from last week, LeadingAge said it was pleased that House bill set out “a truly sustainable reform of the physician payment system under Medicare.”
“We look forward to working with Congress and the administration on continued improvements of the efficiency and effectiveness of Medicare benefits like removal of therapy caps and clarification of observation days in hospitals and the three-day rules,” the organization said in a statement.
President and CEO Larry Minnix added it was “encouraging that Congress is taking the doc fix bull by the horns in a bipartisan way.”