Nursing home operators hail 'historic' Senate passage of permanent 'doc fix' bill

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The Senate overwhelmingly voted to pass H.R. 2 Tuesday night, paving the way for repeal of the Medicare Sustainable Growth Rate and drawing the praise of the largest nursing home association in the country.

“This is a historic day in Washington,” said AHCA President and CEO Mark Parkinson in a prepared statement. “The Senate's bipartisan effort to pass H.R. 2 is a proud moment for our country and will impact millions of patients, families and providers in a truly positive way.”

The Senate vote was 92-8. President Obama had said earlier he would sign such a bill into law. The Senate's decisive action on its second day back after spring recess staved off the actual processing of 21.2% Medicare payment cuts for physicians, which technically went into effect April 1.

Parkinson had expressed strong, but qualified, support for H.R. 2 after the House passed it last month. He again interjected a prod for Congress to go further and tackle other reforms that would directly benefit long-term care providers.

“This legislation is the first step in establishing long-term stability to the profession,” Parkinson said. “The next step includes a continued bipartisan effort in other important areas, such as thoughtful payment reform.”

Senators attempted to pass six amendments to H.R. 2 Tuesday, but all failed. Some lawmakers opposed it because only about one-third of the $200 billion cost will be paid for by beneficiary and provider givebacks. One proposal was to require Congress to pay for the entire package, but 12 Republicans joined with all Democrats to defeat it 58-42.

Among other aspects, the bill includes a six-month delay in enforcement of the CMS' controversial “two midnights” payment policy for short hospital stays.

The SGR repeal will put physicians on a two-track payment system that will strongly continue a federal push toward risk-based payment models, which include accountable care organizations and bundled payment models that nursing homes can figure heavily into.

Doctors will have to have at least 25% of Medicare revenue tied to such payment models by 2019 to qualify for higher payments. That level triples in 2023.