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AHAs March Advocacy Day meetings aim to keep focus on hospitals issues

February 21, 2014

Congress returns to Capitol Hill next week with bipartisan legislation to overhaul Medicare’s physician payments on its plate, and providers focused on the March 31 expiration of a temporary physician payment patch and Medicare “extender” provisions.

House and Senate health care leaders Feb. 6 introduced the SGR Repeal and Medicare Provider Payment Modernization Act (H.R. 4015/S. 2000).

The legislation would repeal the current sustainable growth rate or SGR formula but does not specify how the new program would be funded.

Under the legislation, physicians would receive a 0.5% increase for each of the next five years as Medicare transitions to an alternative payment model designed to reward physicians based on the quality of care provided, rather than the quantity, as the current payment formula does.

The legislation does not include Medicare extender policies, like reauthorizing the Medicare-dependent hospitals (MDH) program and lowvolume adjustments for certain rural hospitals. The MDH and low-volume adjustment were included as permanent programs in the SGR-replacement measure approved by the Senate Finance Committee in December.

Whether Congress can approve legislation overhauling physician payments by March 31 or will opt for another short-term “doc fix” is an open question.

But the AHA is adamant that Congress reject any effort to cut hospital payments again when it addresses the physician payment issue and Medicare extenders.

The AHA has scheduled a series of Advocacy Day meetings
in the weeks leading up to the March 31 deadline to help hospital leaders urge Congress to reject further hospital cuts as a way of paying for either a temporary or permanent SGR fix, and to advance their issues in the Medicare debate on Capitol Hill. Congress extends the Medicare sequester. Before Congress left Washington for the Presidents’ Day recess, it approved legislation that pays for the reversal of a $6 billion cut to military pensions by extending for another year the sequestration for mandatory spending – including Medicare – until 2024. The AHA, along with eight other organizations representing the nation’s hospitals, expressed strong opposition to using Medicare funds for non-health care related purposes in letters to members of Congress.

“While we do not oppose the repeal of the reduction in the cost-of-living adjustment for military retirees, we do oppose using Medicare reductions to pay for non-Medicare related spending,” wrote the AHA, America’s Essential Hospitals,
 Association of American Medical Colleges, Catholic Health Association of the United States, Children’s Hospitals Association, Federation of American Hospitals, National Association of Psychiatric Health Systems, Premier Healthcare Alliance and VHA Inc.


In the Feb. 12 letter, the groups noted that Medicare has been cut repeatedly – most recently under December’s budget agreement. “Medicare is meant to assure seniors access to needed medical care, not serve as a piggybank for other programs,” the letter stated. “It is bad policy to further extend Medicare sequester cuts that could undermine care for seniors.”

For more on the letter, click on: http://tinyurl.com/pku6y4m.

Even after addressing the military pension issue, extending the sequester for another year creates about $2.3 billion in savings; the bill would reserve these savings to pay for future adjustments to the SGR for Medicare physician reimbursements.

In a separate vote, Congress approved a “clean” bill to raise the nation’s debt ceiling and extend the government’s borrowing authority through March 15, 2015.

Rural hospital leaders seek support.

Meanwhile, AHA President and CEO Rich Umbdenstock encouraged more than 500 rural hospital leaders to take their concerns to their legislators at a Feb. 11 special grassroots advocacy briefing held during the AHA-hosted 2014 Rural Health Care Leadership Conference in Phoenix.

“Decisions made by policymakers and legislators in Washington are having a profound effect on rural hospitals,” Umbdenstock told rural hospital leaders. “If your legislators don’t hear from you, they will assume that you are OK with those decisions. We need to stave off possible cuts and send Washington a strong message: protect rural health care!”

Attendees were briefed by Lisa Kidder, the AHA’s vice president of legislative affairs, and Priya Bathija, an AHA senior associate policy director, on the latest rural health care legislative developments from Washington. These included issues like repealing and replacing the SGR formula for physician payment updates, extending various Medicare provisions for rural hospitals, removing the 96hour rule for critical access hospitals, and providing relief from the direct supervision policy for CAHs and rural prospective payment system hospitals with 100 or fewer beds. (For more on the direct supervision issue, see story on the right.) The rural hospital leaders also took part in a special “AHA Virtual Advocacy Day,” engaging their lawmakers through emails, phone calls and social media.

For more, click on: http://tinyurl.com/mb8x3am.