On March 27, 2014, the House of Representatives approved a bill (H.R. 4302) by voice vote to extend Medicare physician pay rates through March 31, 2015 after House Republican leaders scrambled to round up support for the measure. Following the House action, the one-year patch for Medicare's physician pay rates, which are otherwise scheduled to be cut by 24% beginning April 1, was sent to the Senate. Passage of a version of the "Doc Fix" Bill is anticipated early next week.
The Bill contains important provisions impacting long-term care hospitals (LTCHs), including among others, certain limited technical corrections to the recently enacted Pathway for Bipartisan Budget Act of 2013/SGR Reform Act of 2013. Of greatest urgency, however, is a provision contained in Section 112 of the Bill that could impact de novo LTCH projects and satellites under development by requiring these projects to have achieved certain development milestones by the date of passage of the Bill. Specifically, proposed LTCHs and satellites under development must satisfy one of the following by the date of the Bill's passage:
- Begun their six-month average length of stay qualifying period for payment as an LTCH (note that this exception does not apply to satellites since there is no 6-monh qualifying period for the establishment of a satellite facility); or
- Entered into a binding written agreement with an outside, unrelated party for the actual construction, renovation, lease or demolition, and has expended at least 10% of the estimated cost of the project (or, if less, $2,500,000); or
- Obtained a certificate of need, as may be required, in a certificate of need state.
These moratorium qualifying exceptions are almost identical to those that were implemented when the Medicare, Medicaid and SCHIP Extension Act of 2007, as amended (MMSEA), became effective in 2007. Therefore the following CMS resources explaining the original MMSEA moratorium will likely be instructive in helping LTCH providers understand the contours of the exceptions contained in the Bill:
- http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM6172.pdf
- http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/downloads/scletter10_25.pdf
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