Senate Expected to Pass House SGR/ICD-10/Two-Midnight Bill on Monday

The U.S. Senate on March 31 is expected to vote on and pass the House version (H.R. 4302) of legislation to put another annual patch on the Medicare SGR payment formula for physicians, delay the ICD-10 compliance date to October 2015 and further delay enforcement of the Medicare two-midnight payment policy until March 2015.


The U.S. Senate on March 31 is expected to vote on and pass the House version (H.R. 4302) of legislation to put another annual patch on the Medicare SGR payment formula for physicians, delay the ICD-10 compliance date to October 2015 and further delay enforcement of the Medicare two-midnight payment policy until March 2015.

That’s the word from Ken Willis, a spokesperson for the Senate Finance Committee. The Senate for Monday has scheduled three hours of debate on the House bill--without the offering of amendments--and a vote around 5:00-5:30 p.m. EST.  Senate passage will require 60 votes.

The Centers for Medicare and Medicaid Services has told the Finance Committee that while March 31 is the expiration date of the current SGR patch that prevents large decreases in Medicare payments to physicians, in reality a congressional deal needs to be done by the end of next week to prevent payment disruption to physicians. So even if a deal isn’t sealed on Monday, doctors will get their regular payment levels the rest of the week. Willis, however, emphasizes that the intention on Monday is to “get this done sooner rather than later.”

Sen. Ron Wyden (D-Ore.), recently installed as chair of the Finance Committee, has introduced a Senate version of legislation to eliminate the SGR and replace it with a new payment mechanism. But text of the bill, S. 2157, was not available for much of Friday and the House and Senate are not close to agreement on how to replace the SGR.

Some government affairs professionals in healthcare organizations and associations mirror Willis’ comments.

Dan Haley, vice president of government and regulatory affairs at healthcare software and billing services vendor athenahealth Inc., understands that House and Senate leadership would be shocked if the House version does not pass the Senate on Monday. “If ever there is a done deal, this is it,” said Haley.

A spokesperson for the American Hospital Association says the organization’s understanding is that language in the House bill to delay the ICD-10 compliance date a year until Oct. 1, 2015, was asked by some physician associations. The American Health Information Management Association, in a message to members, says, “The insertion of the ICD-10 delay section into H.R. 4302 was likely done to placate physicians who are against an SGR patch.”

A government affairs professional at a physician association who asked not to be identified declined to comment on the ICD-10 issue but confirmed the Senate will vote on the House bill. A spokesperson for the American Medical Association did not respond to a request for comment on the Senate plans and if physicians in fact asked for the ICD-10 delay.

Click here for details on the March 27 passage of the legislation in the House.  Click here for information on language in the bill that further delays Medicare enforcement of the two-midnight payment policy for hospitals.

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