Nursing home leaders and operators are crossing their fingers that a new proposal will give them a four- to six-month reprieve from having to possibly finance a plan via reimbursement reductions to avert scheduled 21% physician Medicare rate cuts.
Skilled nursing facilities have long been bracing for the bad news their reimbursements would be cut to keep physician payment rates stable. They may get relief under the Medicare Provider Payment Modernization Act (H.R. 4015, S. 2000), a long-term comprehensive reform package that is back in play after stalling in 2014.
The proposed $215 billion plan for a permanent so-called ‘doc fix’ would come from splitting the cost among providers and beneficiaries, according to the bipartisan Committee for a Responsible Federal Budget, which released its plan this week.
It would include $100 billion in provider reforms that include expanded use of payment bundling, changes to accountable care organizations and reductions in preventable hospital admissions. It would also involve about $100 billion in beneficiary incentive changes, including modernizing Medicare Part A and B cost-sharing rules and restricting first-dollar Medigap coverage. Another $15 billion would come from Medicaid cuts.
By mandate, physicians participating in the Medicare program would see their rates drop 21% if a solution isn’t approved by April 1.
According to published reports, current efforts likely will stave off physician rate cuts for at least four to six months. If approved, it would be Congress’ 18th “patch” to Medicare’s physician payment system.
Meanwhile, a full repeal of the current physician payment system could happen as early as the end of the current fiscal year in September. It would likely be tied to funding extension proposals for the Childrens’ Health Insurance Program, observers say.</p>