CMS has posted data on hospital charges associated with the 100 most common Medicare inpatient stays. In a fact sheet announcing the availability of the data, CMS highlighted the “significant variation in charges from hospital to hospital — including those within the same community — for inpatient services that may be provided in connection with

As required by law, on March 1, 2013, President Obama issued a sequestration order triggering automatic cuts to a wide range of federal programs, including Medicare payments to providers and health plans. On March 8, 2013, CMS released its first guidance on sequestration, in the form of an “e-News” message to providers. CMS confirms that

Due to continuing budget gridlock in Washington, sequestration has been triggered – meaning automatic cuts to a wide range of federal programs, including Medicare payments to providers and health plans. While the Centers for Medicare & Medicaid Services has not yet announced detailed plans for implementing the sequester requirements for its programs, this Alert answers

On January 2, 2013, President Obama signed into law (via autopen) the “fiscal cliff” deal, H.R. 8, the American Taxpayer Relief Act of 2012 (ATRA). In addition to making well-publicized changes to the tax code, the new law includes numerous Medicare payment provisions. Most notably, the law includes a one-year Medicare physician fee schedule (MPFS) fix that is paid for by approximately $30 billion in other health care (mainly Medicare) spending reductions over 10 years. ATRA also delays until March 2013 the automatic, across-the-board “sequestration” cuts in federal spending imposed by the Budget Control Act of 2011, which are expected to reduce Medicare provider payments by more than $11 billion in fiscal year (FY) 2013 and $123 billion over the period of FY 2013 to 2021. The delay in sequestration, coupled with the government again reaching its debt ceiling, sets up another near-term battle on federal spending, during which Medicare, Medicaid, and other health care programs could be targeted for even more significant cuts.

The health provisions of ATRA are summarized in our client alert.
Continue Reading Fiscal Cliff Deal Includes Medicare Cuts and Other Health Policy Changes

Medicare providers are facing $11.085 billion in automatic, across-the-board cuts for fiscal year (FY) 2013 under the terms of last year’s political compromise regarding the debt ceiling. Pursuant to this legislation, known as the Budget Control Act (BCA), the Office of Management and Budget (OMB) issued a report on September 14, 2012 detailing the spending cuts, known as sequestration, that will be triggered under the BCA. The cuts will go into effect on January 2, 2013 unless Congress and the Administration reach agreement on an alternative budget deal that supersedes the BCA – action that is unlikely to be considered until after the November elections and possibly not until 2013.
Continue Reading Budget Sequestration (“Fiscal Cliff”) to Cost Medicare Providers $11 Billion in FY 2013, White House Reports

MedPAC has released its 2012 Data Book on “Health Care Spending and the Medicare Program.” The publication provides information on national health care and Medicare spending, Medicare and dual-eligible beneficiary demographics, Medicare quality, and Medicare beneficiary and other payer liability. It also includes data regarding various provider types, such as data on Medicare spending, beneficiary

On May 10, 2012, the House of Representatives approved H.R. 5652, the Sequester Replacement Reconciliation Act of 2012, on a largely party-line vote. The legislation would replace certain across-the-board cuts to defense and domestic spending scheduled to begin in 2013 under last year’s Budget Control Act with a new package of domestic spending reductions made

On February 22, 2012, President Obama signed into law H.R. 3630, the Middle Class Tax Relief and Job Creation Act, which was approved by Congress on February 17. In addition to extending a payroll tax cut through the end of the year and extending unemployment benefits, the new law includes a number of Medicare and Medicaid provisions, including a provision temporarily averting a steep cut in Medicare physician payments. The following are highlights of the health policy provisions included in H.R. 3630 and accompanying conference report (House Report 112-399).
Continue Reading President Obama Signs Payroll Tax Bill with Medicare/Medicaid Provisions

On February 13, 2012, President Obama released his proposed fiscal year (FY) 2013 budget.  The budget includes a number of legislative proposals – some of which were included in the President’s September 2011 deficit reduction plan — that would reduce Medicare spending by $302.8 billion and cut Medicaid spending by $55.7 billion over 10 years.  Highlights are available after the jump.
Continue Reading President Obama Proposes FY 2013 Budget

On February 9, 2012, CMS will host a national provider call on the Medicare Spending Per Beneficiary Measure (MSPB).  The MSPB measure was finalized for inclusion in Hospital Value-Based Purchasing (VBP) program in the FY 2012 hospital inpatient prospective payment system final rule. The call will provide background information and discuss how the measure is

On December 23, 2011, President Obama signed into law H.R. 3765, the Temporary Payroll Tax Cut Continuation Act of 2011.  Among other things, the law freezes Medicare physician fee schedule (MPFS) rates at 2011 levels through February 2012, temporarily averting a scheduled 27.4% cut under the statutory Sustainable Growth Rate (SGR) formula. The measure