April 10, 2014

Protecting Access to Medicare Act of 2014

On April 1, President Obama signed into law the Protecting Access to Medicare Act of 2014. The new law prevents a 24-percent cut in Medicare reimbursements to physicians and other practitioners that were scheduled to take effect on April 1, 2014. The law also maintains the 0.5 percent Medicare reimbursement increase to physicians through Dec. 31, 2014, and provides no change to the 2015 Medicare Physician Fee Schedule (MPFS) through March 31, 2015. As noted in last week's FHALink, the law includes a delay to the implementation of ICD-10 until at least Oct. 1, 2015, as well as the following hospital-specific provisions:

  • extends the Medicare-Dependent Hospital Program, low-volume adjustment and ambulance add-on payments through March 31, 2015
  • delays the start of the Medicaid Disproportionate Share (DSH) hospital cuts for one year, until 2017, while extending the cuts for an additional year through 2024
  • extends the partial delay in enforcement of the Centers for Medicare & Medicaid Services' (CMS) two-midnight policy for an additional six months, through March 31, 2015
  • provides technical corrections to the long-term care hospital (LTCH) site-neutral payment policy to clarify that only Medicare fee-for-service discharges will be used to calculate the LTCH
  • discharge payment percentage, and establishing an exception to the LTCH moratorium
  • doubles the Medicare sequester in the first six months of 2024 to 4 percent, but eliminating it in the last six months of that year
  • requires CMS to use private payer rate information to reform Medicare's clinical laboratory payment rates
  • creates a value-based payment system for skilled-nursing facilities (SNFs) based on individual SNF performance on a hospital readmission measure by Oct. 1, 2018
  • extends the Two-Midnight Rule "probe and educate" period through March 31, 2015
  • prohibits Recovery Audit Contractors from post-payment determinations of claims, from Oct. 1, 2013 through March 31, 2015, for patient status determinations, unless there is evidence of
  • systematic gaming, fraud, abuse, or delays in the provision of care by a provider

For more information, contact Kathy Reep, vice president of financial services, at (407) 841-6230.