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Health Care Professionals Descend on Washington

Tom Williams/CQ Roll Call
Rasmussen, center, of the American Hospital Association, said hospitals are underpaid and that a Medicare Payment Advisory Commission recommendation would reduce hospital payments up to 80 percent for the 10 most common outpatient services.

The AHA held a “fly-in” to bring hospital leaders from around the country to Capitol Hill on Nov. 29, and it has another event planned for Dec. 11. The group is running ads and plans to release a series of studies showing the effect the cuts would have on providers and on patient access. In addition, it is pushing a campaign for hospital workers to contact their representatives.

“Grass roots is obviously always king,” Pollack said. “We have hospitals in every congressional district in America that need to be working on this on that end as well.”

The AHA is particularly concerned about once again facing payment cuts to help offset the cost of the next doc fix — the one-year patch to stop an almost 27 percent cut in Medicare provider reimbursements beginning Jan. 1.

The group worries that Congress will use a recommendation from the Medicare Payment Advisory Commission to cap payments for services performed in hospital outpatient departments at the usually lower rate paid for those services when they are performed in physicians’ private offices.

Erik Rasmussen, senior associate director at the AHA, said the commission’s goal of moving services to less expensive places is “not a bad idea.” But, he added, hospitals are already underpaid, and the recommendation would reduce hospital payments up to 80 percent for the 10 most common outpatient services.

“We support the docs getting fixed,” Rasmussen said. “But we’re concerned — this is not the way for the payments to get fixed.”

The American Physical Therapists Association is also homing in on specific items, worried that the high-profile negotiations around the fiscal cliff will overshadow other issues.

“It’s our responsibility to make sure that some of these long-standing beneficiary- focused, rehabilitation-focused things aren’t lost in all that static,” said Justin Moore, the group’s vice president of government and payment advocacy.

The physical therapists’ goal is to extend an exceptions process for the Medicare cap on payments to various outpatient therapy services, including physical, occupational and speech and language therapy. The exceptions process, one of the “Medicare extenders,” was extended earlier this year, in the same package that included the doc fix.

Without action, the exceptions process that allows patients to get covered care above a certain amount will expire, said Moore, meaning that patients will have to pay more for the same amount of care.

More than 50 patient groups are lobbying on a variety of budget issues, including lengthening the therapy-caps-exception process, as part of a “30 Days to Deadline” activity this week.

“We’re doing a lot to try to put the patient face on the therapy cap issue specifically,” Moore said.

Other groups are taking a wait-and-see approach. Chip Kahn, president of the Federation of American Hospitals, says his group is focused for now on what comes out of the deficit talks between the White House and congressional leadership.

Although the group is concerned about extending expiring payment provisions for rural hospitals, as well as the doc fix and its offsets, the big deficit reduction deal could affect some of those smaller issues, he said.

“All those things are important, but the big picture is going to set the tracks,” Kahn said. “We have to approach the thing probably a little bit differently than some of the groups ... that are really one-issue groups.”

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