OMB Begins Review of 2016 Medicare Payment Rules

On October 13, the Office of Management and Budget ("OMB") began its review of four separate 2016 Medicare payment rules. Each rule is required to be released by November 1.

The first three rules under review would revise Medicare Part A payment rates for hospital outpatient departments and ambulatory surgical centers (CMS-1633-FC; RIN 0938-AS42), end-stage renal disease treatment facilities (CMS-1628-F; RIN 0938-AS48) and home health agencies (CMS-1625-F; RIN 0938-AS46). In July, CMS released a proposed rule that would cut payments made to hospital outpatient departments by $43 million, or 0.2 percent, in 2016. Congress urged CMS to improve the transparency of the data used to justify the cut to ensure the annual update for hospitals remains positive. Home health agencies would also see a Medicare payment cut of $350 million under the proposed Home Health Prospective Payment System updates.

The fourth rule would make changes to physician fee schedule payment policies under Medicare Part B. CMS released the 2016 proposed physician fee schedule rule in July.

Debt Ceiling Deadline Set

Senior U.S. Treasury Department officials told Congress this week that lawmakers have until November 5, 2015 to raise the debt ceiling. According to Treasury Secretary Jacob Lew, November 5 is when the federal government will use the last of the so-called "extraordinary measures" it employs to extend the country's borrowing authority in the absence of congressional action.

Retiring House Speaker John Boehner (R-OH) wants to pass a "clean" debt ceiling hike before he leaves office, which could be as soon as October 29. Some conservative Republicans might again demand that any measure to raise the debt limit be tied to spending cuts, which President Obama has indicated he will oppose.

CMS Announces Leadership Changes

CMS recently announced a number of changes at the leadership level. CMS Chief of Staff Mandy Cohen will take on a new role of chief operating officer on November 1, 2015. Karen Jackson, who is currently deputy director of the Innovation Center, will become acting deputy chief operating officer and be responsible for working with teams throughout CMS to improve delivery to beneficiaries in the regions and in the Central Office. CMS also announced Tim Gronniger will become deputy chief of staff and Lisa Watkins will be named senior advisor.

Health-Related Bills Introduced This Week

The House and Senate were out this week.

Next Week in Washington

The Senate returns on Monday, October 19, and the House returns on Tuesday, October 20. It is believed that Ways and Means Chairman Paul Ryan (R-WI) will announce next week whether he plans to seek the position of Speaker of the House. If Ryan forgoes running for the speaker position, the field will be wide open with close to a dozen members that could seek the top House position.

Late last week, the House Budget Committee approved a reconciliation package that would repeal five key portions of the Affordable Care Act, starting with the individual mandate. The House may take up this reconciliation language as early as next week.