On April 16, President Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015. The passage of this bill represents a historic, bipartisan, bicameral effort to repeal the Medicare physician Sustainable growth rate (SGR) formula after 18 years, and 17 temporary "patches." The first major piece of health care legislation since the 2010 Affordable Care Act, the legislation provides payment updates for physicians over a decade and encourages the adoption of "alternative payment mechanisms."
Among its key provisions, the legislation repeals the SGR formula, thereby retrospectively halting a 21 percent cut to Medicare payments to physicians and other health care professionals that took effect on April 1.
Olympic Medical Center's advocacy team actively communicated with our federal representatives in Washington, DC, over the past several months to ensure any SGR patch or fix didn't come at the cost of Medicare cuts to safety net hospitals, and the team is very pleased with the results of this bill.
Leading up to this legislation, hospitals across the nation
feared deep Medicare reimbursement cuts as a way to fund the SGR fix. It’s disappointing that hospitals – specifically rural,
safety net hospitals – continue to be looked to as an area of savings, given
Medicare already pays less than the cost of delivering services to
beneficiaries. We will continue our vigilance to fight further Medicare cuts,
and address proposed legislation and policies we feel will potentially harm
health care access and quality medical care for our constituents.
Current State Policy Priorities
- Stop hospital-based clinic cuts. OMC is working to ensure continued and adequate payment for hospital-based clinics. In communities like Port Angeles, hospital owned clinics are the main provider or primary and specialty care. Hospital-based clinic cuts to Medicaid reimbursement would drastically reduce payment to OMC hospital clinics that provide needed primary and specialty care physician services. Hospital-based clinic cuts would result in an annual reimbursement cut of $800,000 annually to OMC. Update: Currently hospital-based clinic cuts are not included in the Senate or House budgets. Until the Washington State Legislature agrees on a budget, OMC continues to monitor the situation to ensure hospital-based cuts do not return as way to balance the budget.
- Support pre-pack medication bill (HB-1402 and SB-5460). Clallam County does not have a 24-hour pharmacy. Pre-pack medications allow patients to be given certain medications when they are in the emergency department after hours. This bill will allow OMC to continue this practice to best serve our patients needs. Update: The pre-pack medication bill has passed the House and the Senate and awaits Governor Jay Inslee's signature.
- Support Telemedicine bill (HB-1403 and SB-5175). OMC is advocating for telemedicine legislation to guarantee that if an insurer covers a clinical service on an in-person basis, they will also cover the same service if it is provided using video technology. Update: The Telemedicine bill was signed into law by Governor Jay Inslee on April 17!