As the Joint Committee on Deficit Reduction’s first deadline of Nov. 23 seems unlikely to be met and the second deadline (Dec. 31) looms, the College of American Pathologists (CAP) continues meeting with staff of the Super Committee and leading lawmakers—including House Speaker John Boehner (R-OH)—on three advocacy priorities: removing anatomic pathology (AP) from the in-office ancillary services (IOAS) exception to the Stark Law, extending the technical component (TC) grandfather provision, and repealing and replacing the flawed Medicare physician payment formula under the sustainable growth rate (SGR), currently slated to be cut by 27.4% by the end of the year.
These meetings between lawmakers and CAP members have focused on how closing the IOAS loophole can contribute to significant healthcare savings without harming delivery of healthcare services. The Super Committee has little time to deliver on its charge to recommend to Congress $1.2 trillion to $1.5 trillion in cuts. The CAP had been pushing Congress to support a legislative fix to closing the IOAS loophole before Thanksgiving, as part of the deficit reduction plan.
The CAP also is continuing to advocate for the extension of the TC grandfather provision, as the CMS is proposing to end this provision, which allows independent laboratories, under certain conditions, to bill Medicare for the TC of surgical pathology services for hospital patients. Without Congressional action, this provision will expire on Dec. 31.
The CAP expects Congress to continue to negotiate on a package of spending cuts through the end of the year. Since the Super Committee seems likely to miss its first deadline of November 23, Congress could opt to extend its deadline for producing such a package to closer to its second deadline, Dec. 31. If this happens, it raises the possibility that sequestration will be triggered in 2013, which would produce a 2% across-the-board Medicare cut in 2013.
According to the CAP, the SGR and TC grandfather issue may be addressed separately outside the Super Committee process, as the $300 billion price tag to permanently correct the SGR may be untenable in the current fiscal environment. Congress may opt to grant a one or two-year solution instead.