February 2012 Washington Update

AGS Continues Efforts to Avert Medicare Payment Cuts to Healthcare Providers  

In January 2012, the AGS continued its public policy advocacy efforts aimed at averting a looming 27.4% cut in Medicare payments to physicians and other healthcare providers, including nurse practitioners and physician assistants, paid under the physician fee schedule. Medicare’s flawed sustainable growth rate (SGR) formula will trigger the cut March 1, 2012, unless Congress votes to block it. The cut would have taken effect on January 1, 2012, but just days before Christmas, Congress voted to postpone the cut until March 1.

The AGS and those who have joined its advocacy campaign are urging lawmakers to block the cuts and replace the SGR with a workable payment formula. The problematic SGR formula mandates cuts in Medicare payments to healthcare providers whenever increases in outlays for their services exceed annual growth in gross domestic product. For years, Congress has voted, often at the eleventh hour, to postpone SGR-mandated payment cuts. Each time, this has set the stage for larger cuts in the following year.

In a promising development in December 2011, Rep. Allyson Schwartz (D-PA) was appointed to the joint Senate-House conference committee charged with both finding a solution to the Medicare payment formula problem, and extending middle class tax cuts and unemployment assistance. Rep. Schwartz is the author of a proposal to permanently repeal the SGR formula and replace it with a viable alternative.

As January 2012 neared an end, the AGS was monitoring developments of the “megabus” appropriations bill for fiscal year 2012 that Congress approved in December 2011. The bill appropriates $1.1 billion for the National Institute on Aging (NIA), slightly more than was allocated the past fiscal year; appropriates $581 million for the Veterans Affairs Office of Research and Development, the same amount as allocated in fiscal year 2011; and maintains funding for the geriatrics nursing program under Title VIII, with a $4.5 million allocation. Funding for Title VII geriatrics health professions programs is lower than last fiscal year, declining from $33.5 million to $31 million.

Following the passage of the megabus bill, both chambers voted to adopt a resolution that will apply a 1.83% across-the-board cut to all Department of Health and Human Services programs. These include workforce training programs established under Title VII and VIII of the Public Health Service Act, and NIA funding. In early February, it was still unclear which specific programs might be affected.

The AGS applauded the Department of Labor’s proposal, announced in December 2011, to extend Fair Labor Standards Act protections to home care workers. The AGS had long urged the department to do so, as had the Eldercare Workforce Alliance (EWA), which is co-convened by Nancy Lundebjerg, AGS chief operating officer. The extension of these protections to these workers was, in fact, one of the first issues the EWA championed. Currently, the nation’s nearly two million home care workers are excluded from federal minimum wage and overtime protections. This new proposal would ensure home care workers these protections.

In a letter to Secretary of Labor Hilda Solis, the EWA noted that direct-care workers—who are currently responsible for providing 70% to 80% of the paid hands-on, long-term care for older adults in the United States—are important members of the interdisciplinary care team. The proposed change signifies an understanding on the part of the Obama Administration that recruitment and retention of a quality workforce is essential to providing quality care.

In a show of support for the National Institute on Aging (NIA), the AGS signed a January 2012 letter urging National Institutes of Health (NIH) Director Francis Collins, MD, to request $1.4 billion for the institute in fiscal year 2013. This measure would increase funding for the NIA by $300 million. The letter was spearheaded by Friends of the National Institute on Aging (FoNIA), an organization of which the AGS has long been a member. The AGS regularly participates in FoNIA meetings, discussions, and letter-writing efforts aimed at securing much-needed additional funding for NIA research initiatives.

In December 2011, the AGS endorsed the Medicare Home Health Planning Improvement Act of 2011. The legislation would ensure that older adults and disabled citizens receive timely access to home health services by enabling physician assistants, nurse practitioners, clinical nurse specialists, and certified nurse midwives to order home healthcare for Medicare patients. The society signed a letter by the National Association for Home Care and Hospice (www.nahc.org), asking members of Congress to cosponsor this important bill.