CHA News Article

Senate Passes House SGR Patch
Legislation includes post-acute care provisions, California GPCI fix

Yesterday, the U.S. Senate passed H.R. 4302, the Protecting Access to Medicare Act of 2014, averting for one year cuts to physicians required by the sustainable growth rate (SGR). The bill, which passed the House last week, also contains a California-specific provision to make adjustments to the Geographic Practice Cost Index (GPCI), which sets locality for payments to physicians. For many years physicians in 14 California counties have experienced reduced payments because of the GPCI, and the legislation will allow for a more accurate locality adjustment in those counties beginning in January of 2017. In addition to the California GPCI fix, the legislation also includes several provisions of interest to providers of post-acute care services. President Obama has indicated he will sign the bill. A summary of the bill’s hospital-related provisions is available here.

Post-Acute Care Services

Long-Term Care Hospitals (LTCHs) – The Act makes significant changes to the moratorium on new LTCHs and LTCH beds. Previously scheduled to start on Jan. 1, 2015, the moratorium now becomes effective with the enactment of the Act. It also establishes exceptions for certain long-term care hospitals and makes technical corrections to the new LTCH criteria and site-neutral payment policy that will take effect in federal fiscal year 2016.

Skilled-Nursing Facilities (SNFs) – This provision of the Act establishes a skilled-nursing facility value-based purchasing program addressing hospital readmissions by Oct. 1, 2019.

Outpatient Therapy – The Act extends the Medicare therapy caps exception process through March 31, 2015. The exceptions process allows providers to seek and obtain authorization to deliver therapy services above the annual financial limitation (cap) based upon the patient’s medical needs.