With efforts to approve a comprehensive JOBS bill stalled in the Senate, on June 18 the House passed a stand-alone bill (H.R. 3962) that restores the 21.3 percent Medicare reimbursement cut to physicians and provides a 2.2 percent increase in Medicare physician payments through November 30. The bill passed 471 in favor and only one opposed.
Unfortunately Congress is funding the physician fix, in part, through a $4.2 billion cut to hospitals. The hospital cut contained in the bill is achieved by restricting the ability of hospitals to unbundle therapy-related services within 72 hours of an admission if those services are unrelated to the admission. This provision changes the three-day payment window rule to require all therapeutic services delivered in the outpatient department, except for ambulance and dialysis services, to be billed as part of the inpatient hospital’s DRG payment. Hospitals will be prohibited from resubmitting any past claims where therapeutic services could have been unbundled.
The approved bill also includes a new provision that will allow the IRS and CMS to coordinate data-matching efforts with regard to delinquent tax debts owed by Medicare providers, and to take such information into account when releasing reimbursement payments and accepting new providers. The Joint Committee on Taxation estimates this would save $425 million over 10 years.
If you have any questions, please contact Susan Thompson at susan.thompson@wellstar.org.
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