From the April 2015 issue of HealthCare Business News magazine

Also, some of these off-campus hospital outpatient departments could be in rural areas where they were explicitly placed to serve as an outpost for care to patients that might then be transferred to the acute care hospital some distance away. The president’s budget for 2016 also continues the longstanding policy feud regarding excluding certain services from the in-office ancillary exception list. Being on this list allows these services to be ordered and provided by a physician in their office using equipment that they or the practice owns.

Others, such as MedPAC, have found this policy proposal to be shortsighted and possibly in conflict with integrated patient care – and has recommended against limiting the Stark Law exception for ancillary services, citing potential “unintended consequences.” So what happens next? And if these proposals were to be considered, what would be the timeline for Congress? Each chamber’s Budget Committee is looking to introduce their resolutions by April 1, with the hope to pass them by April 15. Depending on timing and need, they may have a conference committee and look to work out a joint resolution. From there, Congress will start the process of trying to allocate funding to all government agencies and get agreement on that by October 1. Any agency not funded could be rolled into an omnibus bill or have a continuing resolution.


This omnibus bill could also be used to pass Medicare and Medicaid reforms and Congress could use a process called reconciliation to allow proposals in the omnibus bill that affect the Federal budget to be considered in the Senate with a vote of only 50 senators, versus 60. For Medicare and Medicaid policy an important date, which would line up with the appropriations process, could be September 30, as Ways and Means Committee Chairman Paul Ryan would like to get all the various budget and tax policy related deadlines to be aligned for 2015.

About the author: Jill Rathbun is managing partner at Galileo Consulting Group, in Arlington, VA. She will be commenting for DOTmed HealthCare Business News magazine on such vital issues for all health care professionals as the implications of the President’s FY 2016 budget, the new makeup of Congress, possible Medicare payment proposals from the Centers for Medicare and Medicaid Services, reports from the Medicare Payment Advisory and more

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