Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


CMS Provides Update on the Status of Provisions Expiring on April 1

The Centers for Medicare and Medicaid Services (CMS) has reconfirmed that while the negative 21 percent physician payment rate cut was scheduled to take effect on April 1, 2015, when the current sustainable growth rate (SGR) patch expired, the agency will limit the impact on Medicare providers by holding claims for a short period of time. This will allow CMS to implement subsequent legislative action while minimizing disruption of provider cash flow. Under current law, electronic claims are paid no sooner than 14 days after the date of receipt. Paper claims are paid no sooner than 29 days after the date of receipt. Claims for services furnished on or before March 31 are not affected by the payment cut and will be processed as normal. However, providers and beneficiaries may be affected by other provisions expiring on April 1, including exceptions for the Medicare Part B outpatient therapy cap, add-on payments for ambulance services, and payments for low-volume hospitals and Medicare dependent hospitals. In regard to the SGR, CMS will provide more information about next steps by April 11.

CDC Releases New Data on Office-Based Physicians Acceptance of New Patients

In 2013, 95.3 percent of office-based physicians were accepting new patients, according to data released by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS). The National Electronic Health Records Survey (NEHRS) also revealed that the percentage of physicians accepting new Medicaid patients (68.9 percent) was significantly lower than the percentage accepting new Medicare patients (83.7 percent) or new privately insured patients (84.7 percent). Acceptance rates varied across the country, with New Jersey, California, Florida, and New York physicians being least likely to accept to Medicaid patients. The acceptance rate of new Medicaid patients ranged from 38.7 percent in New Jersey to 96.5 percent in Nebraska. The full NCHS Data Brief can be found here.

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