On Tuesday night, April 14th, the United States Senate agreed 92-8 with a previously House passed bill to replace the Sustainable Growth Rate (SGR) method of Medicare reimbursement with a new system focused upon “quality, value, and accountability”. Commonly referenced as the “Doc Fix”, the legislation applies primarily to physician reimbursement but includes unrelated items and several nuances that bode well for ADS .

Immediately, the bill does not affect adult day services because they are not direct recipients of Medicare reimbursements. However, additional important goals of the legislation are to link Medicare reimbursements to quality metrics and to encourage better care coordination and chronic care management. These stated goals provide an opening to fortify adult day’s efforts for direct Medicare reimbursement.

Here is a link to the Kaiser Health News report and FAQs about the new legislation, which President Obama said he will sign describing it as “a milestone for physicians, and for the seniors and people with disabilities who rely on Medicare for their health care needs.” http://kaiserhealthnews.org/news/faq-could-congress-be-ready-to-fix-medicare-pay-for-doctors-2/

Roy Afflerbach
NADSA Public Policy Advisor