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Over the last week, President Barack Obama signed into law the final pieces of legislation from the 113th Congress. This includes several bills that impact physician anesthesiologists, including a government funding bill and legislation that could have a negative impact on payments issued under the Medicare Physician Fee Schedule.
Cromnibus
On December 16, President Obama signed into law H.R. 83, a government funding bill known as the “Cromnibus,” which provides funding for most government agencies through September 2015. This legislation includes several elements that could impact physician anesthesiologists, including ASA-supported language on the VHA Nursing Handbook.
This $1.1 trillion bill to avert a government shutdown includes language that calls for greater stakeholder input from organizations such as ASA and requests that any new handbooks “do not conflict with other handbooks already in place within the VHA,” a direct reference to the Anesthesia Service Handbook. ASA is pleased to see this support for language supporting physician-led care; it is expected that VA will move forward with their plans to place the VHA Nursing Handbook into the Federal Register in the coming weeks. Find out more about the Handbook-related language in the Cromnibus here.
The Cromnibus funding bill also included provisions impacting the Independent Payment Advisory Board (IPAB), provider nondiscrimination and opioid overdoses. Find out more about those provisions here.
ABLE Act
On December 19, President Obama signed into law a bill written to assist disabled persons that could also result in across-the-board Medicare payment cuts to physicians. The Achieving a Better Life Experience (ABLE) Act, which had bipartisan support in both chambers of Congress, would allow people with disabilities to create special savings accounts for education, housing and other needs without risking their government benefits such as Social Security or Medicaid. Shortly before consideration of the bill in the House of Representatives, however, a last minute budgetary offset or “pay-for” was added to the bill that accelerated and expanded the onerous “misvalued procedure” initiative.
The budgetary “pay-for” impacting the “misvalued procedure” was opposed by many organizations in the medical community. The “misvalued procedure” initiative was included in the most recent patch to the Sustainable Growth Rate (SGR) formula, the Protecting Access to Medicare Act (PAMA), and directs the Centers for Medicare and Medicaid Services (CMS) to identify and address “potentially misvalued” services. CMS must identify threshold savings that amount to 0.5 percent of the total Medicare fee schedule each year from 2017 until 2020. If CMS is not successful in that effort, then the agency must make across-the-board cuts to equal the shortfall amount. The provision included in the ABLE Act tracks the initiatives but changes the threshold and the timeframe. The threshold amount involved increases to 1.0 percent of the fee schedule and the effort begins in 2016. The threshold would reset back to 0.5 percent for 2017 and 2018.
Both the House and Senate have adjourned until the start of the 114th Congress on January 6, 2015.
