Government Shutdown Looming as Congress Dithers

Government Shutdown Looming as Congress Dithers

Like most of the world, I procrastinate when paying my bills. I tend to put them off until the very last minute.

And that pretty much explains Congress’s strategy last year – and they clearly plan on continuing this approach for 2024. The tough stuff, like funding a government, gets put off until it’s coming down to the wire – but then, Congress does something most people can’t: they move the deadlines and keep putting it off.    

And so, Congress is kicking off 2024 with a lot of work on its plate – mostly last year’s work that has been put off until this year. Let’s first talk about this year’s budget.

This past weekend, congressional leaders from both parties announced a kind of agreement on the budget that needs to pass before Jan. 19: that’s the new deadline that Congress had pushed back from last year.

But the announcement last weekend was really just both parties clearing their throats, kind of like when my daughters announce at 9 p.m. that they are going to get started working on their homework … which was actually due yesterday.

A Forbes article cited experts estimating that there’s only a 30-percent chance that Congress will actually pass a budget by Jan. 19. So, go ahead and cue the usual list of consequences that will happen should the government shut down on Jan. 20.

Not mentioned in this round of budget talks is the 3.4-percent cut to the Medicare physician fee schedule. That cut has been in effect since Jan. 1, last week. There are a number of bills that have been passed by the House and Senate that could fix the cut, and late last week the House introduced yet another bill that would cancel it. However, it doesn’t look like any of these bills will make it into the Jan. 19 budget.

The next budget deadline that Congress set for itself was Feb. 2, so we’ll keep our eyes open to see if the cut will be addressed before then.  

If you do the math, we expect a 4.6-percent inflation increase in physician expenses – that’s the yearly Medicare Economic Index – so add the 4, carry the 1, and you’re at an 8-percent shortfall for physicians in 2024.

Looking forward to the rest of the year, there are a number of healthcare policy issues that will impact providers.

Expiring this year: COVID hardship exemptions for the Merit-Based Incentive Payment System – or MIPS. This means that, for some providers, this will be the first year they participate in MIPS – which, depending on one’s performance, can result in a reduction of up to 9 percent in reimbursement for Medicare-covered professional services.

Under construction this year: the government portal for No Surprises Act (NSA) disputes, with upgrades on that portal, promised in a recently proposed rule. Higher dispute resolution fees take effect on Jan. 22 of this year, and NSA lawsuits and appeals promise to continue – so we’ll see plenty of activity here. Also, Congress has a number of bills lined up that will add hospital and health plan transparency requirements and increase enforcement efforts.

Throw in activity on telehealth and artificial intelligence in healthcare, coming from both Congress and the administration, along with policies to fight the opioid epidemic, and the continual administrative struggles of the Medicaid unwinding, and D.C. has a challenging year ahead of it.

One thing we will not see in 2024, despite the fact that it is an election year, is the introduction of any broad, substantive health reform. Both parties and the administration are content with making fixes here and there, but it is unlikely that this Congress – or this or any future administration or Congress – will suggest any overhauls to the system. For substantive health reform, we will look to some interesting experimenting being done at the state level, but we’ll save that for a future article.

Print Friendly, PDF & Email
Facebook
Twitter
LinkedIn

Matthew Albright

Matthew Albright is the chief legislative affairs officer at Zelis Healthcare. Previously, Albright was senior manager at CAQH CORE, and earlier, he was the acting deputy director of the Office of E-Health and Services for the Centers for Medicare & Medicaid Services.

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Frank Cohen shows you how to leverage the Comprehensive Error Rate Testing Program (CERT) to create your own internal coding and billing risk assessment plan, including granular identification of risk areas and prioritizing audit tasks and functions resulting in decreased claim submission errors, reduced risk of audit-related damages, and a smoother, more efficient reimbursement process from Medicare.

April 9, 2024
2024 Observation Services Billing: How to Get It Right

2024 Observation Services Billing: How to Get It Right

Dr. Ronald Hirsch presents an essential “A to Z” review of Observation, including proper use for Medicare, Medicare Advantage, and commercial payers. He addresses the correct use of Observation in medical patients and surgical patients, and how to deal with the billing of unnecessary Observation services, professional fee billing, and more.

March 21, 2024
Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Explore the top-10 federal audit targets for 2024 in our webcast, “Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets,” featuring Certified Compliance Officer Michael G. Calahan, PA, MBA. Gain insights and best practices to proactively address risks, enhance compliance, and ensure financial well-being for your healthcare facility or practice. Join us for a comprehensive guide to successfully navigating the federal audit landscape.

February 22, 2024
Mastering Healthcare Refunds: Navigating Compliance with Confidence

Mastering Healthcare Refunds: Navigating Compliance with Confidence

Join healthcare attorney David Glaser, as he debunks refund myths, clarifies compliance essentials, and empowers healthcare professionals to safeguard facility finances. Uncover the secrets behind when to refund and why it matters. Don’t miss this crucial insight into strategic refund management.

February 29, 2024
2024 SDoH Update: Navigating Coding and Screening Assessment

2024 SDoH Update: Navigating Coding and Screening Assessment

Happy World Health Day! Our exclusive webcast is just $99 for a limited time! Use code WorldHealth24 at checkout before April 12th to claim this discount.

Dive deep into the world of Social Determinants of Health (SDoH) coding with our comprehensive webcast. Explore the latest OPPS codes for 2024, understand SDoH assessments, and discover effective strategies for integrating coding seamlessly into healthcare practices. Gain invaluable insights and practical knowledge to navigate the complexities of SDoH coding confidently. Join us to unlock the potential of coding in promoting holistic patient care.

May 22, 2024
2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

HIM coding expert, Kay Piper, RHIA, CDIP, CCS, reviews the guidance and updates coders and CDIs on important information in each of the AHA’s 2024 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.

April 15, 2024

Trending News

Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →

Happy World Health Day! Our exclusive webcast, ‘2024 SDoH Update: Navigating Coding and Screening Assessment,’  is just $99 for a limited time! Use code WorldHealth24 at checkout.

SPRING INTO SAVINGS! Get 21% OFF during our exclusive two-day sale starting 3/21/2024. Use SPRING24 at checkout to claim this offer. Click here to learn more →