Federal Watch
July 12th, 2012
AGS is tracking developments in Washington and will be providing weekly updates for our readers via our List Serv, americangeriatrics.org, our Facebook page, and our Twitter feed. This week, we update you on several happenings on Capitol Hill. We provide you with a continued update regarding Obama’s signature healthcare law, the recently released 2013 Proposed Medicare Physician Fee Schedule Rule, and HHS’s announcement of 89 new ACOs. We additionally share a relevant Kaiser Health News story around the “cost of care,” and remind you of an upcoming National Provider Call regarding the Medicare Shared Savings Program and Advance Payment Model. Finally, we share our latest efforts, and encourage you to take action by contacting your legislators, and urging them to fully address and put an end to the flawed SGR formula.
House Votes Again to Repeal Healthcare Law
With a vote of 244 to 185, the Republican-controlled House of Representatives voted on July 11th to repeal the Affordable Care Act, President Obama's signature healthcare legislation. The vote came two weeks after the Supreme Court ruled that the law, Obama's signature domestic achievement, was constitutional. According to the Associate Press, "Republicans criticized the law as a job-killing threat to the economic recovery. Democrats said repeal would eliminate consumer protections that already have improved the lives of millions." The latest vote by the House was essentially symbolic. It’s an opportunity for Republicans to further express their opposition and rev up voters before the November elections. The bill will ultimately be stopped by the Democratic-controlled Senate. For more details, you may visit here.
Proposed Medicare Fee Schedule Includes Pay Increase for Primary Care and Family Physicians
On July 6th, the Centers for Medicare & Medicaid Services (CMS) released its annual Proposed Medicare Physician Fee Schedule (PFS) FY 2013, which addresses changes to the fee schedule and other Medicare Part B payment policies to ensure that current payments reflect changes in medical practice and the relative value of services. Most interestingly, the Proposed Rule incorporates a new proposal that would include a 7% pay increase for primary care and family physicians. The rule also includes a proposal that would provide payment for transitions of care management services. As you may recall, last summer AGS held numerous meetings with leaders at CMS, alongside other specialty societies, to discuss the importance of CMS covering services such as care coordination and care transitions. We are pleased to see these discussions reflected in this year’s Proposed Rule. AGS is still in process of reviewing the rule in additional detail and plans to submit comments to CMS by the September 4th deadline. For more information, please click here.
Administration Announces 89 new Accountable Care Organizations
On July 10, HHS Secretary Kathleen Sebelius announced the addition of 89 new Accountable Care Organizations, which as of July 1, began serving 1.2 million people with Medicare in 40 states and Washington, D.C. ACOs are organizations formed by physicians and other health care providers that have agreed to work together to coordinate care for people with Medicare. By participating, providers have an opportunity to share in savings realized through high-quality, well-coordinated care. The 89 new ACOs bring the total number of organizations participating in the Medicare Shared Savings Programs to 154. This includes the 32 Pioneer ACOs announced last December and the six Physician Group Practice Transition Demonstration organizations that began in January 2011. Altogether, more than 2.4 million beneficiaries are receiving care from providers participating in these initiatives.
Teaching Doctors about the Cost of Care
Kaiser Health News provides an in-depth analysis at what the cost of care means in the United States at the moment. The article delves into issues such as the current fee-for-service payment system, graduate medical education, mounting health care costs and dwindling resources -- and how these factors affect the daily decisions of healthcare providers. To read more, please visit here.
REMINDER
Please Note New Date - National Provider Call: Medicare Shared Savings Program and Advance Payment Model Application Process — Tuesday, July 31; 1:30-3 pm ET
Last fall, CMS issued a final rule under the Affordable Care Act to establish the Medicare Shared Savings Program, along with a notice for the Advance Payment Model that will provide additional support to physician-led and rural Accountable Care Organizations (ACOs) participating in the Shared Savings Program. These two initiatives will help providers participate in ACOs to improve quality of care for Medicare patients. On Tuesday, July 31, 2012, CMS will host a National Provider Call, where subject matter experts will provide an overview and updates to the Shared Savings Program application and Advance Payment Model application processes for the January 1, 2013 Shared Savings Program start date. A question and answer session will follow the presentations. The Shared Savings Program Application and the Advance Payment Model web pages have important information, dates, and materials on the application process. Call participants are encouraged to review the applications and materials prior to the call.
What AGS Did This Week
AGS submitted comments to the National Committee for Quality Assurance (NCQA) on several important aspects of the NCQA’s Specialty Practice Recognition Program. We specifically commented on proposals regarding eligibility, the role of nurse practitioners and physicians assistants, care coordination, and meaningful use stage 2 requirements. To see the overview of NCQA’s draft standards that we commented on, you may visit here.
How You Can Help
AGS encourages you to Take Action by visiting AGS’ Health in Aging Advocacy Center. Contact your members of Congress today, and urge them to call for both the repeal of the SGR and comprehensive Medicare payment and delivery reform. Should you have any questions, please don’t hesitate to contact Susie Sherman, Senior Coordinator of Public Affairs & Advocacy, ssherman@americangeriatrics.org.
Modified On: July 12th, 2012
