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I know many of you have been hearing about changes to Medicare payments and the SGR, and you may be wondering what it all means for LCSWs. Given the fact that the 158-page bill, HR 1470, now HR 2, Medicare Access and CHIP Reauthorization Act (MACRA), was created last week and released yesterday, this preliminary analysis of the bill should not be considered complete. More information will be coming but this will give you a summary of what HR 2, will and will not do, if passed.
First an important note: Without some action by Congress in the next week, all Medicare providers, including LCSWs, will receive a 21% cut in reimbursement as of April 1. That's when the SGR regulations - the ones that have been "kicked down the road" 17 times - will go into effect. Something needs to happen: the SGR cuts finally happen, an 18th postponement, or perhaps HR 1470, which looks like a real possibility.
There are five major parts to HR 2 that are important to LCSWs as follows: 1) a new Medicare reimbursement formula; 2) a continued implementation of Medicare services based on quality measures (including PQRS); 3) an increase in premiums for higher income Medicare beneficiaries; 4) a two-year continuation of the CHIP program to provide Medicaid services for children; and 5) a more restrictive abortion policy.
Obviously the last two are not directly connected to Medicare policy, but as often happens in Congress, issues which would have difficulty passing on their own are often attached to bills that are likely to pass.
Here is what is meant by each of the five points above:
Getting this bill passed will require enormous effort. CSWA believes that the current ambiguity of the bill makes it difficult to actively support it. As the form of the bill becomes clearer, we may be able to support or oppose the bill, or weigh in on parts of it, based on how it affects LCSWs.
CSWA hopes this summary is helpful in understanding what is a complicated, potentially helpful, bill.
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