“Between now and Dec. 13 there is this conference committee. If you look at the Ryan and Murray budgets, it's like Venus and Mars and hard to imagine they're going to come together on anything that's significant,” Pollack said, referring to House Budget Committee Chairman Paul Ryan (R-Wis.) and Senate Budget Committee Chairman Patty Murray (D-Wash.), who will serve as the new panel's co-leaders. He fears that they will decide on a deficit-reduction package to mitigate the sequester that could hurt providers.
The whole menu of options for healthcare reductions—including payments to critical-access hospitals, graduate medical education, the Medicaid provider tax, coding offsets and hospital bad debt—will again be in play. And prospects for a repeal is the Medicare sustainable growth-rate formula, which would cost about $139 billion over 10 years, are slim.
In an advisory to clients this week, Eric Zimmerman, a partner with the firm McDermott Will and Emery, also warned that providers could be at risk for greater cuts as a result of the upcoming fiscal talks. He reminded clients that the last time a budget conference committee convened in late 2011 following the Deficit Reduction and Budget Control Act in August of that year, it led to the sequester's 2% across-the-board cut to Medicare spending.
“The extension of government spending to January 15th is not an arbitrary date,” Zimmerman wrote. “January 15th is when the next round of sequestration cuts are set to be implemented. Both parties want to reopen the sequestration mandate, and lining up this process with the next sequestration implementation date creates that opportunity.”