F:\P\H13\CMS\MEDCR\EXTDPKGE_06.XML XXXXXXXXXX XXXXXXXXXX 12/11/2013 13:08 XXXXXXXXXX 12/10/2013 23:21 f:\VHLC\121113\121113.063.xml 12/11/2013 13:09:27 XXXXXXXXXX 565941|8 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX [Discussion Draft] [Discussion Draft] 113th CONGRESS 1st Session Amendment to H.J. Res 59 Offered by M_. ______ Insert at the end of the House amendment the following: B

Medicare and Other Health Provisions

1001.

Short title; table of contents

(a)

Short title

This division may be cited as the Pathway for SGR Reform Act of 2013. (b)

Table of contents

The table of contents of this division is as follows: Division B—Medicare and Other Health Provisions Sec. 1001. Short title; table of contents. Sec. 1002. Findings; purpose statement. Title I—Medicare Extenders Sec. 1101. Physician payment update. Sec. 1102. Extension of work GPCI floor. Sec. 1103. Extension of therapy cap exceptions process. Sec. 1104. Extension of ambulance add-ons. Sec. 1105. Medicare inpatient hospital payment adjustment for low-volume hospitals. Sec. 1106. Medicare-dependent hospital (MDH) program. Sec. 1107. 1-year extension of authorization for special needs plans. Sec. 1108. 1-year extension of Medicare reasonable cost contracts. Sec. 1109. Extension of existing funding for contract with consensus-based entity. Sec. 1110. Extension of funding outreach and assistance for low-income programs. Title II—Other Health Provisions Sec. 1201. Extension of the qualifying individual (QI) program. Sec. 1202. Temporary extension of transitional medical assistance (TMA). Sec. 1203. Extension of funding for family-to-family health information centers. Sec. 1204. Delay of reductions to Medicaid DSH allotments. Sec. 1205. Realignment of the Medicare sequester for fiscal year 2023. Sec. 1206. Payment for inpatient services in long-term care hospitals (LTCHs).

1002.

Findings; purpose statement

In order to support the provision of quality care for our nations seniors, Congress finds it appropriate to reform physician reimbursements under the Medicare program. SGR reform legislation provides such an opportunity, but not until next year. In order to facilitate such reform, Congress finds that the Centers for Medicare & Medicaid Services should continue to focus its efforts on the following areas: (1)

Simplify and Reduce Administrative Burden on Physicians

The application and assessment of measures and other activities under SGR reform should be facilitated by the Centers for Medicare and Medicaid Services (CMS) in a way that accounts for the administrative burden such measurement places on physicians. Therefore, the Congress encourages CMS to identify and implement, to the extent practicable, mechanisms to ensure that the application and assessment of measures be coordinated across programs. (2)

Timely Feedback for Physicians

In order for measure and assessment programs to encourage the highest quality care for Medicare seniors, the Congress finds it critical that CMS provide physicians with feedback on performance in as close to real time as possible. Such timely feedback will ensure that physicians can excel under a system of meaningful measurement. (3)

Encourage Development of New Models

There is great need to test alternatives to Fee-For-Service reimbursement in the Medicare program. One option is the promotion and adoption of new models of care for physicians. To date, there has been significant development and testing of models for primary care. Congress supports these efforts and encourages them to continue in the future. Congress also encourages the development and testing of models of specialty care.