Federal Update: More Budget News

Medicare Therapy Caps/ICD-10 Delay/SNF Value-Based Purchasing

H.R. 4302, the temporary Medicare physician reimbursement legislation containing these provisions, passed the Senate on Monday night and has been signed into law.

Thanks to all of you who generated support for this legislation. Although we would have preferred a permanent solution to the therapy caps issue, we are pleased that a temporary extension of the exceptions process was included in the bill. This fulfilled one of our primary advocacy goals for this year.

Medicare Observation Days

We are still advocating for congressional action on H.R. 1179/S. 569, to require all time a Medicare beneficiary spends in the hospital to count toward the three-day stay requirement. We are up to 140 cosponsors in the House; 25 in the Senate.

Fiscal 2015 Budget

In spite of having negotiated a budget agreement covering fiscal 2015 back in December, Rep. Paul Ryan, Chair of the House Budget Committee, has submitted another budget plan for 2015.

This budget plan contains provisions similar to those in Rep. Ryan’s budget plans from the last few years – modified Medicare voucher plan, Medicaid block grants, cuts to housing and services programs, repeal of the Affordable Care Act, etc. Talking points on the plan are attached.

If the U.S. House of Representatives leadership determines that this budget plan can get enough votes to pass, there will be a floor vote next week.

However, since December’s budget deal, negotiated by Rep. Ryan with his opposite number in the Senate, covered fiscal 2015, there is no procedural need for another budget plan. And in fact appropriations committees on both sides of the Hill are working on a bipartisan basis to develop fiscal 2015 spending bills in line with the budget Congress passed in December. Both Republican and Democratic appropriators want to get the spending bills done on a timely basis.

Like any budget plan, Rep. Ryan’s “Path to Prosperity” has something for everyone to hate. Some conservatives already have criticized it as not cutting enough spending. Moderates and liberals are concerned about the amount of spending it would cut.

This year, every member of the House has to run for reelection, and many House members have to fight off primary challenges in addition to the general election. Given those dynamics, a majority of House members may not want to cast a vote on a budget plan that is unneeded and that potentially opens them up to criticism from opponents from both parties.

In the event the House does take up this budget plan and pass it, there is no chance it will be considered by the Senate.

This is what we know at this point. Have a great weekend. We’re finally starting to see some cherry blossoms here in DC.