MedPAC Issues Draft Recommendations for 2014 Medicare Payment Update Factors

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Explore:  Medicare MedPAC

On December 6, 2012, the Medicare Payment Advisory Commission (MedPAC) issued draft recommendations for Medicare payment update factors for 2014.  MedPAC, which advises Congress on issues affecting Medicare, included recommendations for inpatient and outpatient hospitals, skilled nursing facilities, inpatient rehabilitation facilities, long term care hospitals, hospice, and ambulatory surgical center services (ASCs). 

Among other changes, the recommendations would increase Medicare payment rates for hospitals in FY 2014 by 1%.  This rate is .8% less than the statutory update—with the purpose of allowing HHS to recoup past documentation- and coding adjustment- based overpayments to hospitals.

Further, MedPAC also called for a repeal of the sustainable growth rate formula (SGR), which is to cut Medicare physician payments by 26.5% starting on Jan. 1.  Instead of the SGR formula, MedPAC suggested ten years of statutory payment updates.  MedPAC also issued recommendations for a .5% payment increase for ASCs in 2013.  Additionally, it recommended it be mandatory for ASCs to submit cost data starting in CY 2014.

The complete list of draft recommendations are:

Rate Year 2014

 

Provider

Draft Recommendation

Hospitals - Inpatient & Outpatient

Net Payment Update by 1.0%

Skilled Nursing Facilities

No Market Basket Update for FY2014 - Rebase

Home Health

No Market Basket Update for FY2014 - 2Yr Rebase

Physicians

Reiterate October 2011 SGR repeal letter to Congress

Ambulatory Surgery Centers

Update by 0.5%

Dialysis

No Market Basket Update for FY2014

Hospice

No Market Basket Update for FY2014

Long-Term Care Hospitals

No Market Basket Update for FY2014

Inpatient Rehabilitation

No Market Basket Update for FY2014

The final recommendations will be voted on at the January 17, 2013 MedPAC meeting, and will be included in MedPAC’s annual Medicare Payment Policy Report to Congress in March.

For more information, please click here.

Reporter, Katy Lucas, Atlanta, +1 404 572 2822, klucas@kslaw.com.

Topics:  Medicare, MedPAC

Published In: Administrative Agency Updates, Health Updates, Insurance Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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