CMS grants Maryland hospital spending waiver

January 13, 2014
health care reformSeveral publications, both large circulation newspapers and niche sources, reported over the weekend on Federal approval of Maryland’s initiative to control hospital costs.

In an article entitled “Maryland Experiments With Capping Hospital Spending,” the Wall Street Journal (1/10, Dooren, Schatz, Subscription Publication) reported that the Centers for Medicare and Medicaid Services (CMS) approved a waiver to Maryland to set its own Medicare rates for hospitals. Maryland agreed to save $330 million in Medicare cost savings over five years. The plan waiver was supported by the state’s major hospitals and insurance companies.
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House, Senate Committees approve bill to overhaul how Medicare physicians are paid

December 16, 2013
capitalThe Wall Street Journal (12/13, Schatz, Subscription Publication) (12/13, Schatz, Subscription Publication) reported that the House Ways and Means Committee and the Senate Finance Committee on Thursday approved legislation to revamp how Medicare physicians are paid. The measure would scrap the current way physicians are reimbursed by Medicare and replace it with a system under which doctors would be rewarded for meeting quality standards. In a statement, the AMA lauded the move. Because lawmakers have not determined how to pay for the legislation, it is not expected to pass before the end of the year.

The Washington Times (12/13, Howell) reported that lawmakers “both parties said they were driven by the desire to provide year-over-year certainty to doctors and the seniors under their care.” The Times quotes Senate Finance Chairman Max Baucus (D-MT) as saying, “After a decade of Band-Aid solutions, it is time for this committee to act. I am proud to say that today we are taking the first step.”
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Senate and House to take up permanent SGR repeal

December 11, 2013
The AP (12/11, Alonso-Zaldivar) reports that both Democrats and Republicans now favor a permanent change to “Medicare’s broken physician payment policy,” known as the “sustainable growth rate” (SGR) and are working towards a new system that would contain “financial carrots and sticks for doctors to provide quality, cost-effective care” for Medicare patients, with “up to 10 percent of an individual physician’s pay” connected to “quality indicators.” This week, the Senate Finance Committee is expected to take up “a broad bipartisan framework” on the matter which will also be taken up by the House Ways and Means Committee. Yet, Congress will still have to adopt a “temporary patch” for early 2014, as no one expects agreement on a plan before the beginning of the year. The biggest obstacle to that is the need to find “offsets” to the cost of the temporary fix. As to the permanent fix, the AMA is said to be “reserving judgment.”

The National Journal (12/11, Ritger, Subscription Publication) reports that one reason why a permanent repeal of the Sustainable Growth Rate seems likely is that the cost over ten years has now fallen according to the CBO from over $150 billion to $116.5 billion. Still, it “won’t happen before the holiday recess.” One version of a permanent replacement, attributed to the House Ways and Means committee, would adjust physicians’ payments, starting in 2017, “based on four performance metrics: quality of care, budget-neutral resource use, meaningful use of electronic health records, and clinical-practice improvement activities.”

The Hill (12/10, Viebeck) reports in its “Healthwatch” blog that a three month patch is expected. CQ (12/11, Ethridge, Subscription Publication) reports that both Senate Finance and House Ways and Means committees are expected to take up permanent plans tomorrow, but have not “announced plans to bring a short-term patch to either chamber’s floor.”

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