Washington Update

Washington Update: February 2013

“Fiscal Cliff” and Threats to Medicare Payments and Programs Averted

Following an intensive advocacy campaign in which the American Geriatrics Society (AGS) and organizations nationwide urged Congress to prevent a fiscal crisis that would have triggered across-the-board spending reductions, lawmakers approved an eleventh-hour deal to avert the cuts. The cutbacks would have taken effect after January 1, 2013, had President Obama and lawmakers been unable to agree on an alternative deficit-reduction plan. The threatened cuts were so sweeping they were likened to a “fiscal cliff.”

In addition to the government-wide spending cuts, the sustainable growth rate (SGR) formula would have instituted a 26.5% reduction in Medicare payments to physicians and certain other healthcare providers. The spending cuts would also have adversely affected funding to the National Institute on Aging, the geriatrics education training programs under Titles VII and VIII of the Public Health Service Act, and many other programs. 

Voting in favor of the deal, lawmakers agreed to postpone the 26.5% reduction in Medicare payments—a cut mandated by Congress’ problematic SGR—until January 1, 2014. The SGR triggers cuts in Medicare payments to physicians when outlays for their services exceed annual limits. For years now, however, the SGR has mandated untenable cuts and Congress has stepped in to block them, postponing the cuts another year and setting the stage for deeper cuts in subsequent years.

“Although Congress’ vote to postpone the 26.5% cut provides temporary relief, we are disappointed that lawmakers have yet to repeal the SGR and replace it with a truly viable alternative,” said AGS Chief Executive Officer Jennie Chin Hansen. “We will continue to advocate for comprehensive Medicare payment and delivery reform.” 

In the months leading to the January 1 deadline, the AGS and its members urged lawmakers to avert the sweeping cutbacks. The society sent letters to key policymakers and launched advocacy efforts via its Health in Aging Advocacy Center. The AGS also launched a successful campaign that encouraged advocates of quality care to urge their lawmakers to block a proposal that would eliminate a payment increase for primary care providers caring for Medicaid patients that was slated to take effect on January 1.

Joint Commission Establishes New Nursing and Rehabilitation Center Accreditation

The Joint Commission has launched a new Nursing and Rehabilitation Center Accreditation program, and for the first time is offering a Rehabilitation and Advanced Care Certification option. The new program, which replaces the Long-Term Care Accreditation program, is designed to help providers achieve, maintain, and demonstrate excellence in the services they provide. 

Both the accreditation program and certification option are the products of a year-long initiative that gathered input from consumers, providers, payers, and other stakeholders. The standards, survey process, and certification option will be effective on July 1, 2013.

AGS Co-Signs Letter Calling on President and Congressional Leaders to Provide Better Access to Mental Healthcare  

In the wake of the tragic deaths of 20 children and six teachers at a Connecticut elementary school in December 2012, the American Medical Association has sent President Obama and the leaders of the House and Senate a letter signed by the American Geriatrics Society and nearly 50 other healthcare organizations emphasizing the importance of better access to mental healthcare in the United States.

“While the overwhelming majority of patients with mental illness are not violent, physicians and other health professionals must be trained to respond to those who have a mental illness that might make them more prone to commit violence,” the letter notes. Among other things, adequate funding for both research in violence prevention in general—and gun violence in particular—is imperative, the letter notes.

“Of equal importance is providing sufficient access to mental health services,” the authors add. “While we strongly supported the passage of the Mental Health Parity Act of 2008, unfortunately, the promise of better access to psychiatric treatment will not be a reality absent federal and state funding. This effort should be combined with an education campaign that reduces the stigma of seeking mental health services.” The lettercan be viewed at www.americangeriatrics.org/files/documents/Adv_Resources/Gun_Violence_Letter_President.pdf