On Monday evening, March 31st, the U.S. Senate passed a 12-month extension to the scheduled Medicare Sustainable Growth Rate (SGR) physician cuts—otherwise known as the “doc fix”. The House had previously passed the bill the week before and it easily passed the Senate with a vote of 64 to 35, although it’s important to note that it is only a short-term fix rather than the permanent solution that some Senators and Representatives had advocated for.
While the SGR itself does not impact Health Centers directly, there are a number of interesting provisions included in the one-year bill that are important. A complete summary of the legislation can be found here, though most notably it includes a one-year delay of ICD-10; extension of Transitional Medical Assistance (TMA), which provides Medicaid coverage for families transitioning from welfare to work; extension of Medicaid and CHIP “Express Lane” enrollment; and an eight-state demonstration program for “Certified Community Behavioral Health Clinics” with a Medicaid payment system similar to Health Centers’ unique PPS methodology. NACHC is neutral on the Behavioral Health Clinic provision and has not taken a formal position on the comprehensive legislative package.