Editor’s Note: This story has been updated to include comments from the American Health Care Association/National Center for Assisted Living.
Medicare providers stand to lose more than $36 billion in reimbursements next year, a fate that looks more likely after Congressional leaders failed to stop slated cuts as part of a spending deal last week.
A short-term government funding bill passed by Congress on Thursday and signed by President Joe Biden (D) on Friday keeps the government operating through Feb. 18. But to get the bill passed, Democrats dropped plans to avert looming cuts to Medicare over objections from Republicans.
Industry stakeholders have pushed Congress to address a soon-ending moratorium on the 2% sequestration of Medicare payments, automatic cuts to the Medicare program under an anti-deficit provision known as PAYGO and scheduled Medicare Physician Fee cuts.
“Nursing facility patients are facing multiple cuts to their Part B services,” explained Cynthia Morton, executive vice president of the National Association for the Support of Long Term Care. “Plus, 2% sequestration goes back into effect and we don’t know if Congress will waive PAYGO as they have continued to do in the past, which is a 4% cut. Our sector has been hit so hard with COVID, and these reductions just make it ever more difficult in an already very difficult environment.”
The Congressional Budget Office in February estimated that the Medicare program could be cut by $36 billion through PAYGO alone. Morton added that industry stakeholders “have not given up and will not give up on” preventing that.
“We continue outreach to members of Congress to advocate for an extension of the Medicare sequester relief before the end of the year,” the American Health Care Association/National Center for Assisted Living said in a statement to McKnight’s Monday. “We are hopeful that lawmakers will recognize that we are still in the midst of this pandemic and providers need these critical resources to help care for our nation’s most vulnerable.”
In the law’s 11 year history, Congress has never let PAYGO cuts affect Medicare payments.
“Congress has time to act before [Dec.] 31,” Morton told McKnight’s Long-Term Care News on Friday. “We are appealing to any and all champions to help. There is some thought that Congress could act next year and perhaps make their fix retroactive, but the damage will be done because the cuts will go into effect and providers have to make decisions about how they can continue to provide care.”