The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) released the following statement regarding upcoming government deadlines for passing a budget, resolving fiscal cliff issues, and funding federal agencies and the impact on O&P and healthcare:
Congress and the President dodged another potential downgrade in our nation’s credit rating when they agreed to pass legislation to suspend the debt ceiling-the amount of debt that Congress authorizes our federal government to incur-until May 19, 2013. This does not solve any of the problems associated with the debt ceiling other than the immediate concern of a U.S. government default on the country’s financial obligations. In exchange for this suspension, each house of Congress will have to produce a budget by April 15 or risk having congressional pay withheld. The Senate has not passed a budget in the past four years and this move forces them to do so.
The next major date that may forge some bipartisan action comes at the end of February when the current two-month delay in sequestration, or across-the-board spending cuts, expires unless Congress acts to delay these cuts again or passes some kind of alternative to sequestration that saves an equal amount of money. If sequestration goes into effect on March 1, many government officials and economists believe it could be devastating for the overall economy and lead to an increase in unemployment. Despite these dire warnings, there does not appear to be a consensus alternative approach emerging from either political party, at least not yet. (Recall that the last fiscal cliff deal occurred within about 48 hours of January 1, and culminated in congressional votes on that day.)
If sequestration takes effect on March 1, all Medicare providers will receive a 2 percent cut in their fees. How long it will take the Centers for Medicare & Medicaid Services (CMS) to implement these cuts is not known, nor is it known whether this will delay payment for claims pending after March 1. This 2 percent cut will also apply to the O&P fee schedule, which was raised by 0.8 percent on January 1, 2013, to reflect annual inflation. As bad as this is for all Medicare providers, many believe this is far preferable to passage of a major Medicare bill that reduces spending over ten years by as much as $400 to $600 billion. This is the number being discussed in the context of potentially striking a “grand bargain” on reduction of the deficit and debt.
Another key date is March 26, 2013. This is the date the current continuing resolution (CR) expires. The CR is currently funding all federal agencies at 2012 funding levels. Without passage of another CR or passage of a final set of appropriations bills for fiscal year (FY) 2013, which ends on September 30, 2013, the federal government will shut down as it did in 1994 and 1995. This is additional leverage for Republicans, primarily, who want to ensure that federal spending is reduced in a meaningful way, particularly through the reform of entitlement programs such as Medicare, Medicaid, and even social security.
Meanwhile, on issues much more specific to O&P, the U.S. Department of Health and Human Services continues to crank out reams of regulations implementing the Affordable Care Act (ACA), including regulations on the essential benefits package for both private insurance and Medicaid plans. Six Republican governors have now said they will expand their Medicaid programs in 2014 under the ACA, including Ohio and Michigan, if their state legislatures agree. And CMS continues to issue onerous physician documentation standards for O&P claims that are causing serious problems for claims denials in the field. NAAOP will continue to address all of these issues and ensure the O&P community’s voice continues to be heard.