Washington Update: President Obama Signs the Medicare Access and CHIP Reauthorization Act

Alison Dye
Katie O. Orrico

On April 16, 2015, President Obama signed into law the “Medicare Access and CHIP Reauthorization Act,” which repealed Medicare’s sustainable growth rate (SGR) physician payment system and prevented a 21 percent pay cut. In addition, the legislation:

  • Consolidates the current Physician Quality Reporting System (PQRS), Electronic Health Record (EHR), and Value-Based Payment Modifier (VM) programs, and eliminates the penalties associated with these programs
  • Includes positive incentives for quality improvement payment programs that allow all physicians the opportunity to earn bonus payments
  • Enhances the ability of physicians—rather than the government—to develop quality measures and clinical practice improve-ment activities
  • Clarifies that quality improvement program requirements do not create new standards of care for purposes of medical malpractice lawsuits
  • Reverses the CMS decision to eliminate the 
  • 10-and 90-day global surgery payments
  • Extends the Children’s Health Insurance Program (CHIP) for two years

The CNS and the AANS will now focus on guiding this legislation through the implementation process to ensure that the Centers for Medicare and Medicaid Services (CMS) develops the new Medicare physician payment system as directed and intended by Congress.

Congress Advances Legislation Repeal the Medical Device Tax
On June 2, 2015, the House Ways and Means Committee favorably reported out HR 160, the “Protect Medical Innovation Act,” by a vote of 25–14. The bill would repeal the 2.3 percent medical device excise tax that was adopted as part of the Affordable Care Act (ACA). All the Republican members of the panel, along with Rep. Ron Kind (D, Wisconsin) voted in support. Additionally, several Dem-ocrats—including Reps. Xavier Becerra (D, California), John Larson (D, Connecticut), and Mike Thompson (D, California)—expressed support for the bill. The CNS and AANS urged passage and commended the committee for taking this important step to further medical innovation.

Earlier this year, on April 23, 2015, the Health Subcommittee of the US Senate Finance Committee held a hearing on the impact of the medical device tax on jobs, innovation, and patients. Created by the Affordable Care Act, the medical device tax is a 2.3 percent excise tax that applies to the gross sales of medical device products. This tax imposes more than $30 billion in new taxes and is adversely affecting medical innovation and patient care. Repealing the medical device tax is among neurosurgery’s top legislative priorities, and the CNS and AANS issued a press release applauding the committee for its efforts to abolish this arbi-trary tax.

House Ways and Means Committee Votes to Repeal IPAB
On June 2, 2015, the House Ways and Means Committee voted in favor of HR 1190, the “Protecting Seniors’ Access to Medicare Act.” This legislation would repeal the IPAB and passed the committee by a vote of 31–8. All Republicans supported passage, as did the following Democrats: Reps. John Lewis (D, Georgia); Richard Neal (D, Massachusetts); Mike Thompson (D, California); John Larson (D, Connecticut); Bill Pascrell (D, New Jersey); Danny Davis (D, Illinois); and Linda Sánchez (D, California). Leading a coalition of 450,000 physicians, the CNS urged passage and applauded the committee for advancing this bill.

Prior to the Ways and Means Committee action, on May 7, 2015, the CNS and other neurosurgical societies joined the Healthcare Leadership Council and more than 500 national and state-based healthcare organizations in sending a letter urging Congress to repeal the Independent Payment Advisory Board (IPAB). The IPAB is a board of 15 unelected, and largely unaccountable government bureaucrats, whose primary purpose is to cut Medicare spending. Repealing the IPAB is one of organized neurosurgery’s top legislative priorities.

The CNS Supports Graduate Medical Education Legislation
On May 4, 2015, the CNS joined the Alliance of Specialty Medicine in endorsing S. 1148, the “Resident Physician Shortage Reduction Act of 2015.” Introduced by Sens. Bill Nelson (D, Florida), Harry Reid (D, Nevada) and Charles Schumer (D, New York), S. 1148 would increase the number of Medicare-funded graduate medical education (GME) residency positions by 15,000 over the next five years. The Alliance also endorsed the House companion bill, HR 2124, introduced by Reps. Joseph Crowley (D, New York) and Charles Boustany, MD (R, Louisiana).

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For more information, please contact Katie O. Orrico, director of the Washington Office, at korrico@neurosurgery.org.