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Key Members of Congress Reach Budget Deal; Short Term SGR Fix Could Be Included

Posted on 12/12/2013 by NTOCC ® in Public Policy Updates
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Yesterday evening, House Budget Chairman Paul Ryan (R-WI) and Senate Budget Chairwoman Patty Murray (D-OR) reached a two-year budget agreement in advance of the December 13th deadline. In total, the bipartisan package amounts to $85 billion, which includes about $63 billion to replace the sequestration cuts in 2014 and 2015, and over $22 billion in net deficit reduction. The agreement would set the discretionary spending level for fiscal year 2014 at $1.012 trillion, and $1.014 trillion in FY 2015. In practical terms, if the bill passes and is signed into law, appropriations committees still have to allocate the funds among subcommittees, and the subcommittees have to divide their allocations among their programs. These committees must work fast to come up with appropriations bills in advance of the January 15th deadline, but having a common spending target and budget framework will greatly enhance the likelihood that they can keep the government running and avoid another shut down.

Importantly, a three-month “patch” to stave off the cut in Medicare physician reimbursements set to go into effect at the end of the year could be added to the budget deal to allow time for members further negotiate the long-term repeal of the sustainable growth rate (SGR) formula. The three-month patch would provide a 0.5% increase to physicians which would be funded through an extension of cuts in Medicaid DSH payments and in patient services in long-term care hospitals.  Of particular note for NTOCC members is the patch would also be paid for by a delay in the implementation of the new "two midnight" more rule for hospitals (patient admissions spanning two midnights or more deemed as inpatient).

The Senate Finance and House Ways and Means Committees are set to mark-up their respective long term SGR bills tomorrow. Several amendments have been filed relating to care transitions/coordination policy and, we are monitoring and will be sure to update NTOCC members should these advance.