Update: On December 16, President Barack Obama signed this legislation into law.
On December 11, the U.S. House of Representatives narrowly passed a funding bill to avert a government shutdown, which also included several provisions that could impact ASA members. This comprehensive spending bill, referred to as “Cromnibus,” combines all 12 government funding bills into a single package, with most departments funded through September 2015. Key provisions of importance to physician anesthesiologists include:
VHA Nursing Handbook:
The section pertaining to Military Construction and Veterans Affairs, and Related Agencies includes ASA-supported language addressing the VHA Nursing Handbook, which threatens to remove physician-led, team-based anesthesia care for Veterans within VA.
The bill seeks to hamper the operations of the Independent Payment Advisory Board (IPAB) by rescinding $10 million in funding from the Board’s operations. IPAB, created through the Affordable Care Act, is a non-elected advisory board with unilateral powers to mandate reductions in Medicare Part B payments. ASA has long supported and worked for repeal of IPAB.
Revised - Medicare Physician Fee Schedule Provisions: Report language articulates Congress’s concerns about changes to the surgical global period. The language reflects that the Centers for Medicare and Medicaid Services (CMS) has failed to provide sufficient public comment on the “debundling” of surgical codes outlined in the final Medicare Physician Fee Schedule (MPFS) rules. Further, the report language questions whether proper methodology has been tested to safeguard patient care and patient access, and whether the final rule places excessive administrative burdens on providers. Additionally, Congress encourages CMS to defer implementation of the final rule pending further agency review.
The funding bill proves $3.6 billion for CMS, the same amount as last year’s enacted level.
The bill includes a number of provisions that reflect strong Congressional concerns about overdose deaths attributable to opioids, including provisions relating to emergency devices used to rapidly reverse the effect of opioid overdoses.
The bill includes language directing CMS to issue clarification regarding its interpretation of the nondiscrimination provision of the Affordable Care Act. ASA opposed the inclusion of the nondiscrimination provision in the ACA and has urged CMS to reject the efforts of the non-physician community to expand the implications of the provision.
This legislation will next be considered in the U.S. Senate. If it passes in that chamber, it will go to the President for his signature.
Read more about the ASA-supported VHA Nursing Handbook provision within the “Cromnibus” bill here.