Therapy Management & Consulting Services Blog

Senate Passes SGR Patch

Important Message from the NASL

NASL_2011.jpgOn Monday, March 31, the Senate approved the House-passed 12-month Sustainable Growth Rate (SGR) Patch bill by a 64-35 vote. The proposal, H.R. 4302, Protecting Access to Medicare Act of 2014, prevents a 24% cut in reimbursements for physicians and Part B providers who treat Medicare patients that would have gone into effect on April 1, 2014 and replaces it with a 0.5% update through December 31, 2014 and a 0% update from January 1, 2015 until April 1, 2015.  

The legislation also extends the Part B outpatient therapy cap exceptions and manual medical review process until March 31, 2015; extends the CMS "probe and education" program for auditing hospitals discharges around CMS' two-midnight policy for 6 months; makes technical corrections to the LTCH site neutral payment policy; delays the transition to ICD-10 until October 1, 2015; establishes a SNF
Value-based Purchasing Program that includes an all-cause all-condition readmission measure for nursing facilities; and, increases a fee paid to labs that service patients in skilled nursing facilities. 

Please click here for a summary of the provisions of interest to NASL members.

Visual_May_2010.jpgH.R. 4302 was considered by the House under suspension on March 27.  It will now be sent to the President for his signature. CMS announced March 28 that it plans to hold claims affected by the flawed Medicare physician payment formula for 10 business days if a patch or fix is not passed to avoid the Sustainable Growth Rate cuts by midnight Monday. The agency says it has instructed the Medicare Administrative Contractors to hold claims paid under the physician fee schedule through April 14.