What ODs can expect from the government shutdown

The AOA is closely following developments on Capitol Hill related to the federal government shutdown. The government shutdown started Oct. 1, as a result of a budget impasse between Congress and the president. Discretionary programs and federal employees are the most affected. However, payments for Medicare services, the Affordable Care Act (ACA or "Obamacare") and other mandatory programs continue, though at a slower rate while the government remains officially closed.

Here's an basic overview of what ODs can expect with the government shutdown:

  • Medicare and Medicaid reimbursement continues. Funding for Medicare and Medicaid is mandatory, meaning it is not subject to annual appropriations that lapse during a shutdown.

  • Medicare providers face an additional 2 percent reduction in reimbursements during federal fiscal year 2014, as a result of across-the-board federal spending cuts authorized under the so-called "sequestration" agreement. This comes on top of a previous 2 percent "sequestration" cut already in effect. Health care practitioners are spared the additional cut if Congress omits the sequestration cut in a continuing resolution to maintain government operations or in upcoming debt limit legislation.

  • The federal Center for Consumer Information and Insurance Oversight, the federal agency created to implement the ACA, continues in operation because funding was provided through the ACA.

  • State health insurance exchanges opened as scheduled Oct. 1 and continue in operation thereafter.

During the last government shutdown crisis in the mid-1990s, Medicare continued to pay physicians and hospitals according to prevailing payment rates because claims are made out of the Medicare trust funds and not current appropriations.

AOA members with questions, comments or concerns may contact Jon Hymes, AOA Washington office director, at 800-365-2219 or jfhymes@aoa.org.

October 1, 2013

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