On March 27, 2014, the House of Representatives passed H.R. 4302, which will postpone the scheduled 24% Medicare physician reimbursement cut by an additional one year.  Several groups opposed the Bill as yet another temporary measure that will only postpone a long-term solution.  The Bill also delays the transition to ICD-10 and full implementation of the Two Midnight Rule for inpatient admissions.

Medicare’s Sustainable Growth Rate (SGR) formula calls for a heavy physician pay cut each year.  However, these pay cuts are regularly cancelled by Congress with so-called “doc fix” legislation.  Indeed, the Bill represents the 17th time similar legislation has been passed as a short-term patch.  Earlier in the week, the American Medical Association (AMA) released a statement urging Congress to vote against the measure so that a long-term solution could be reached.

The Bill also contains various other provisions, some of which are controversial.  Section 212 would delay the transition to ICD-10 under the Medicare program until October 1, 2015.  The American Health Information Management Association (AHIMA) opposes this delay and encouraged others to do so as well because it contends the delay will greatly diminish the return on investment in Electronic Health Records (EHRs) and health data exchanges.

Section 111 of the Bill would further delay full implementation of the Two Midnight Rule for inpatient admissions.  Currently, post-payment inpatient status reviews by Recovery Audit Contractors (RACs) for compliance with the Two Midnight Rule are delayed until October 1, 2014, absent evidence of delays in a provider’s provision of care, fraud, abuse, or systemic gaming.  The Bill would extend that period until March 1, 2015.

The Bill will come before the Senate on Monday, March 31st, just one day before the scheduled pay cuts would otherwise take effect. To view the full text of the bill, click here.

Reporter, Isabella Edmundson, Atlanta, +1 404 572 3527, iedmundson@kslaw.com.