Medicare cuts loom...

(This story has been updated with a correction.)

Hospitals are ramping up efforts to forestall a 2% across-the-board cut to Medicare pay for providers next year, even as some congressional healthcare leaders remain unaware that it's coming.

The automatic $1.2 trillion in cuts from Medicare and most non-entitlement programs were required by the Budget Control Act of 2011 after Congress failed to agree on specific deficit-reduction steps by last November. It will cut $116 billion from Medicare providers and Medicare Advantage insurance plans, according to the Bipartisan Policy Center. The so-called sequester will begin Feb. 1, according to the Congressional Budget Office.

The Medicare cuts generated vocal opposition from provider advocates and their congressional supporters before they were formally triggered at the end of 2011. But much of the debate in Congress this year around avoiding the effects of the sequester has focused almost exclusively on the national security and economic impacts of its Defense Department cuts.

Several members of Congress have sought to change that, including Sen. Tom Harkin (D-Iowa), chairman of the Health, Education, Labor and Pensions Committee. He issued a report last week detailing the range of non-Defense impacts. That report specified some healthcare-related cuts, such as the $2.4 billion eliminated from the National Institutes of Health, but omitted any reference to the significant Medicare provider cuts, and for good reason.

“Medicare can't be sequestered because Medicare is not a discretionary account,” Harkin said when Modern Healthcare asked him about the provider cuts.

Harkin was not alone in his view.

“I think Medicare is exempt from the sequester,” Sen. Barbara Mikulski (D-Md.), another senior member of the HELP Committee, said in a July 25 interview.

Such discordant views about the Medicare impacts of the sequester illustrate the extent of the challenge that providers and their advocates face in educating members of Congress about the impacts of those cuts.

“That's frustrating to hear,” Maggie Elehwany, vice president of government affairs and policy at the National Rural Health Association, said when told about those responses from lawmakers. “This was something that was fairly well-publicized at the time it went through, and we have really tried to keep getting the word out.”

That outreach effort to members of Congress continues to ramp up as representatives of about 60 hospitals and health systems plan to lobby members of Congress early this week. Rural hospital leaders plan to follow up with invitations for members of Congress to visit their facilities during the upcoming August recess.

“It's one thing to hear this will impact rural hospitals, but it's another thing to see these facilities and the challenges they are facing,” Elehwany said.

The American Hospital Association also expects its members to focus on the impacts of the sequester at their facilities during their annual congressional advocacy event in September.