Hospitals would get a pay cut while doctors would get a raise under a legislative package expected to be released today and which may move quickly through the House and Senate over the next week.
But the bill will face opposition from the hospital lobby on at least one measure. Under the package, a Medicare policy known as the “72-hour rule” would get refigured, amounting to about a $4.5 billion hit to the hospital sector.
The provision expands the list of services that are not eligible for reimbursement under the Medicare rule. Essentially, it bars the unbundling of payments for therapeutic services unrelated to a hospital admission if they are performed within 72 hours of an admission.
The American Hospital Association estimates the measure would add to the already $155 billion in cuts the sector agreed to as part of the new reform law, and in an e-mail alert, said it would fight the provision.
Recovery audit contractors have said that hospitals are bundling services that could have been billed separately, according to the AHA e-mail.
Meanwhile, the bill—crafted jointly by the House Ways and Means and Senate Finance committees—revises the SGR provision so physicians get a 1.3% update starting June 1 and for the remainder of the year. In 2011, doctors will get a 1% update.
From 2012 through 2013, however, the pay formula gets tweaked. Updates would depend on physicians meeting certain spending targets, according to a summary of the bill.
But the formula backtracks to current law in 2014, setting physicians up with a possible 27% cut, according to one healthcare lobbyist. Doctors face a 21.2% cut by month's end.
Additionally, the package includes a six-month extension to the increase the federal government's share of Medicaid; a 15-month extension of Consolidated Omnibus Budget Reconciliation Act, commonly known as COBRA, premium assistance; and widens the 340B drug discount program to include inpatient drugs for use by patients who are uninsured.
The broader bill, known as the American Jobs and Closing Tax Loopholes Act of 2010, extends a number of expiring tax provisions as well.