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House Passes Short-Term SGR Bill

Posted on 3/27/2014 by NTOCC ® in Public Policy Updates
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Today, the House passed a 12-month patch of the current SGR formula and it now heads to the Senate for a vote. As you may recall, substantial progress had been made on a permanent repeal and replacement of the formula, but negotiators could not come to an agreement on the offsets for a longer-term fix before the March 31st expiration deadline. Thus, Congress is resorting to another patch.

Leaders in both parties have said that this doesn’t mean that they will stop working on the permanent repeal, and Senator Wyden is pushing hard for passage of his repeal bill that includes using war savings as an offset, but that approach has thus far proved to be unpalatable to the majority of Senators and it is therefore unlikely to be successful.  Physician groups have come out against a patch arguing that it will increase the cost of a permanent repeal and that it will kill the momentum for a comprehensive fix, but that opposition is probably not enough to stop its passage in either chamber.

Sections of the House-passed bill of particular interest to NTOCC include:

  • Section 109. Extension of Funding for NQF quality measurement: This provision would extend funding through the first 6 months of fiscal year 2015 for the National Quality Forum (NQF).
  • Section 111. Extension of Two-Midnight Rule for Hospitals: This provision would postpone hospital compliance with the controversial two midnight rule and recovery audits of medically unnecessary claims through March of 2015.
  • Section 215. Skilled Nursing Facility Value-Based Purchasing Program: This provision establishes a skilled nursing facility (SNF) value-based purchasing (VBP) program by October 1, 2019. The SNF VBP program will be based off of individual SNF performance on a hospital readmission measure.  Through the program, CMS would withhold a certain portion of SNFs' Medicare payments and redistribute those dollars to high-performing providers with reduced hospital readmissions.
  • Section 223. Demonstration Programs to Improve Community Mental Health Services: The provision would establish an eight-state demonstration program over a two-year period to incentivize community mental health providers to offer a broad range of mental health services.  In particular, these community mental health centers would be required to coordinate care across settings and providers “to ensure seamless transitions for patients across the full spectrum of health services including acute, chronic, and behavioral health needs.

Please find a section-by-section summary attached. Please click here to view the bill.