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10/1/13 to 10/1/14. On 2/28/14 CMS confirmed no further delays of ICD-10 would occur. The United States is the only developed nation that is still using the ICD-9 code set which was implemented in the 1970s. This delay not only slows the advancement of
Healthcare modernization it negatively impacts patient care, safety, and clinical research of public health data that was set to be implemented 10/1/14. AHIMA estimates this delay will cost upwards of 6 Billion Dollars and stifle advancement in Healthcare infrastructure, technology, and practice.
438:, a procedure that would have required the bill to receive a two-thirds majority to pass. However, when it became clear to the Republican leadership that they did not have enough votes to win a two-thirds majority, they changed the vote to a voice vote instead, scheduling that vote to take place when the House chamber was nearly empty. Opponents of the bill, unaware of this change, were not present to object to the voice vote and force a roll call instead. Rep.
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inpatient hospital costs in the United States. On average, Medicare covers about half (48 percent) of health care costs for enrollees. Medicare enrollees must cover the rest of the cost. These out-of-pocket costs vary depending on the amount of health care a
Medicare enrollee needs. They might include uncovered services—such as long-term, dental, hearing, and vision care—and supplemental insurance.
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474:(D-NV) may have been involved in this decision, since the Senate needed a doc fix bill quickly in order to get one passed before the deadline. Many democratic supporters are disappointed in Nancy Pelosi (D-CA) who pushed House Democrats to a Voice Vote without additional debate or time necessary to submit amendments.
252:" (SGR) formula, was established in 1997 to make planned cuts to Medicare reimbursement rates. Congress has regularly avoided making these cuts since then by passing legislation, colloquially known as the "doc fix", to delay the cuts. Congress has been making these temporary changes for over a decade.
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In 2010, Medicare provided health insurance to 48 million
Americans—40 million people age 65 and older and eight million younger people with disabilities. It was the primary payer for an estimated 15.3 million inpatient stays in 2011, representing 47.2 percent ($ 182.7 billion) of total aggregate
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argued strongly in favor of the SGR Repeal and
Medicare Provider Payment Modernization Act of 2014, calling the current SGR "fiscally foolish" and "fatally-flawed." A coalition of medical groups wrote that "instead of reforming the Medicare physician system, Congress seems intent on imposing yet
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A key addition to this bill not supported by CMS or HHS is
Section 212. This section mandates that The HHS secretary will be blocked from implementing the International Classification of Diseases version 10 (ICD-10-CM/PCS) until 10/1/2015 at the earliest. Previously ICD-10 had been delayed from
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since 1966, that guarantees access to health insurance for
Americans aged 65 and older who have worked and paid into the system, younger people with disabilities, and a few other groups. As a social insurance program, Medicare spreads the financial risk associated with illness across society to
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449:(R-LA) said that, while he did not like the tactic used to get the bill passed, he did think the bill was better than the scheduled sharp reimbursement rate decrease. Fleming said that "they gave us a choice between something bad and something worse."
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of the delay is not paid for, and merely uses an accounting trick to move
Medicare sequester cuts from 2025 to 2024 in order to give the appearance of balancing out. In order to accomplish this, the bill includes a provision that makes it exempt from
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said that she supported the bill because she thought
Republicans would use the situation, if the Medicare cuts went into effect, to attack Obamacare and because she didn't want seniors to worry about their access to their doctors.
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467:(R-TX) called the tactic "outrageous" and said that "now I know that I need to get with some other members and make sure we have people on the floor, since we won't be sure what our own leadership is going to do."
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The
Protecting Access to Medicare Act of 2014 would delay until March 2015 any cuts in the Medicare reimbursement rate. Without this or similar legislation, a 24 percent cut would go into effect on April 1, 2014.
625:
Torio CM, Andrews RM. National
Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2011. HCUP Statistical Brief #160. Agency for Healthcare Research and Quality, Rockville, MD. August 2013.
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protect everyone, and thus has a somewhat different social role from for-profit private insurers, which manage their risk portfolio by adjusting their pricing according to perceived risk.
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physician payment, a cut that had been regularly delayed for over a decade. Because the law only delayed and did not repeal the physician payment cut, it was a source of controversy.
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426:(R-PA) said he still supports a permanent fix and is "sponsoring this bill today because it is my earnest hope that this is the last patch we will have to pass."
401:(D-NJ) opposed the bill because "I simply cannot support yet another temporary SGR patch" and thought that the bill "sets back months and months of hard work."
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To amend the Social Security Act to extend Medicare payments to physicians and other provisions of the Medicare and Medicaid programs, and for other purposes.
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another round of arbitrary provider payment reductions to maintain a corrosive policy that essentially every member of Congress says should be scrapped."
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House Democrats complained that the bill was released too closely to the deadline for passage, preventing anyone from fully understanding its contents.
381:(AMA) also opposed this bill because it wanted a solution that would be long-term, instead of yet another one-year delay. The AMA had supported the
481:(D-MI), the longest serving member of the House, told reporters "I've seen a lot of dumb things, but I've never seen anything as comical as this."
460:, "Short on votes for controversial spending bill, so GOP & Dem leaders rammed it through by 'voice vote' in empty House chamber. Not right."
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442:(R-SC) called the vote "bullshit" and told reporters that he could not talk about "the budget because I am so pissed about the (doc fix)."
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other more targeted Medicare cuts to skilled nursing facilities, lab tests, overvalued physician services, and other providers. However,
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The House Democratic leadership reportedly agreed to this quick change to a voice vote in advance. Pressure from Senate Majority Leader
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argued that the "sequester realignment provision is a pure timing gimmick that produces no real savings and has no effect on the debt."
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Critics of the bill have objected to the fact that there are not enough offsets to balance the increased spending.
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SGR Repeal and Medicare Provider Payment Modernization Act of 2014 (H.R. 4015; 113th Congress)
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SGR Repeal and Medicare Provider Payment Modernization Act of 2014 (H.R. 4015; 113th Congress)
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271:'s individual mandate requirement, a provision that was very unpopular with Democrats.
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The Protecting Access to Medicare Act of 2014 was introduced into the
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Protecting Access to Medicare Act of 2014 (H.R. 4302; 113th Congress)
802:"Gohmert vows constant floor monitoring after 'doc fix' voice vote"
750:"Congress Must Take Fiscal Responsibility and Reform Medicare Now"
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327:. The bill was passed on March 27, 2014, through a controversial
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The Senate voted on March 31, 2014, to pass the bill 64-35 in
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House Republican Conference's legislative digest on H.R. 4302
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The bill was originally scheduled to be considered under a
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signed the bill into law on April 1, 2014, when it became
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The bill was signed into law on April 1, 2014, during the
207:) is a law that delayed until March 2015 a pending cut to
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Congressional Budget Office's Cost Estimate on H.R. 4302
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Kaiser Slides | The Henry J. Kaiser Family Foundation
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United States House Committee on Energy and Commerce
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United States House Committee on Energy and Commerce
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522:"Obama threatens to veto GOP 'doc fix' bill"
477:Some members found the tactic amusing. Rep.
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640:. Facts.kff.org. Retrieved on 2013-07-17.
185:Protecting Access to Medicare Act of 2014
28:Protecting Access to Medicare Act of 2014
925:United States federal health legislation
920:Acts of the 113th United States Congress
602:"House approves 'doc fix' in voice vote"
565:"House GOP readies year-long 'doc fix'"
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869:Library of Congress - Thomas H.R. 4302
385:, instead of this bill. AMA president
309:United States House of Representatives
257:United States House of Representatives
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748:Hoven, Ardis Dee (28 February 2014).
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776:"Doubts rising about 'doc fix' vote"
283:This delay in cuts is predominantly
800:Kasperowicz, Pete (27 March 2014).
600:Kasperowicz, Pete (27 March 2014).
563:Kasperowicz, Pete (26 March 2014).
903:from websites or documents of the
724:"GOP gripes about 'bull----' vote"
349:Tooltip Public Law (United States)
198:Tooltip Public Law (United States)
95:Tooltip Public Law (United States)
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722:Berman, Russell (27 March 2014).
899: This article incorporates
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774:Viebeck, Elise (27 March 2014).
520:Viebeck, Elise (12 March 2014).
496:Medicare Sustainable Growth Rate
33:
845:Statute Compilations collection
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653:. Congressional Budget Office
236:program, administered by the
379:American Medical Association
216:113th United States Congress
63:113th United States Congress
874:beta.congress.gov H.R. 4302
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678:"H.R. 4302 - All Actions"
422:Sponsor of the bill Rep.
315:. It was referred to the
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905:United States Government
680:. United States Congress
228:Medicare (United States)
160:on March 31, 2014 (
150:on March 27, 2014 (
436:suspension of the rules
255:On March 14, 2014, the
250:Sustainable Growth Rate
248:A formula, called the "
238:U.S. federal government
131:Committee consideration
901:public domain material
430:Voice vote controversy
275:Provisions of the bill
879:GovTrack.us H.R. 4302
362:Debate and discussion
313:Rep. Joe Pitts (R-PA)
311:on March 26, 2014 by
125:Rep. Joe Pitts (R-PA)
75:Rep. Joe Pitts (R-PA)
862:US Statutes at Large
269:Affordable Care Act
108:Legislative history
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408:opposed the bill.
303:Procedural history
651:"H.R. 4015 - CBO"
336:Roll Call Vote 93
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158:Passed the Senate
127:on March 26, 2014
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259:passed the
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472:Harry Reid
404:The House
329:voice vote
323:, and the
222:Background
152:voice vote
117:Introduced
86:Public law
42:Long title
860:) in the
840:) in the
424:Joe Pitts
292:one-fifth
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811:27 March
806:The Hill
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780:The Hill
759:13 March
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728:The Hill
684:27 March
657:11 March
611:27 March
606:The Hill
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569:The Hill
531:13 March
526:The Hill
485:See also
285:paid for
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209:Medicare
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