The Latest: The U.S. Senate and House approved a six-month continuing resolution (CR) funding the federal government through the end of the fiscal year and averting any threat of a government shutdown when the current CR expires on March 27. The CR provides flexibility to the Department of Defense and other federal agencies when implementing the sequester. The CR includes a $71 million increase for the National Institutes of Health and would require the administration to obligate all fiscal year 2013 funds appropriated for community health centers. The President is expected to sign the bill.

Background: Congress must address several expiring Medicare provisions important to hospitals, while also addressing overall fiscal provisions that significantly impact the federal deficit. These fiscal issues will directly impact federal spending before the end of the year and, depending on how they are resolved, could create the potential for further hospital payment cuts. Congress will attempt to address the following provisions:

• Expiring payroll tax cut.
• Expiring emergency unemployment benefits.
• Expiring Bush tax cuts.
• Other expiring tax provisions, for example the Alternative Minimum Wage Tax, and Estate Tax.
• The sequestration (automatic spending cuts) scheduled to begin on January 3, 2013.
• An extension of the debt ceiling.

In addition, and competing for the attention of federal lawmakers, Congress must deal with the Medicare physician payment, Medicare extenders, Medicare cuts included in last year’s Budget Control Act (sequestration), and the above detailed expiring tax provisions that will determine the amount of revenue available to address these critical hospital issues. Additional detail about the expiring provisions is in HAP Memo 12-82.

Additional Information:

• 2013 House calendar (days highlighted in brown are session days)
• 2013 Senate calendar
• American Hospital Association National Survey on Core Attitudes Regarding Hospitals (November 2012)
• Protect Hospital Payments in the Federal Budget (video - November 2012)
• Tripp Umbach Report: The Negative Employment Impacts of the Medicare Cuts in the Budget Control Act of 2011 (September 2012)
• American Hospital Association (AHA) Deficit Reduction Alternatives
• American Hospital Association (AHA) Position Papers on:
  • Medicare Graduate Medical Education
  • Medicaid Provider Assessments
  • Medicare Bad Debt Reimbursement
  • Rural or Small Hospitals
  • Post-Acute Care
  • Medicare and Medicaid Payments
  • Hospitals as Employers
• Coalition to Protect America’s Health Care Website

Available Resources:

Facts About Sequestration (April 2013) 3 Page(s) / 149.29 Kb - Download time approximately 1.4 secs on a 1.0 mb connection Adobe Acrobat - Download a viewer for this attachment - How to Download

Pennsylvania Hospital Message (Winter 2013) 3 Page(s) / 127.75 Kb - Download time approximately 1.2 secs on a 1.0 mb connection Adobe Acrobat - Download a viewer for this attachment - How to Download

Charts: Impact of Mandated 2 Percent Sequestration 2 Page(s) / 119.79 Kb - Download time approximately 1.1 secs on a 1.0 mb connection Adobe Acrobat - Download a viewer for this attachment - How to Download

Charts: Impact of Existing Medicare Payment Cuts 2 Page(s) / 159.26 Kb - Download time approximately 1.5 secs on a 1.0 mb connection Adobe Acrobat - Download a viewer for this attachment - How to Download

• Impact on HAP Members of H.R. 8, American Taxpayer Relief Act of 2012 (Fiscal Cliff Legislation)
  HAP Memo
• New Report Finds that Potential Medicare Cuts Could Lead to Nearly 37,400 Jobs Lost in Pennsylvania
  News Release