rate cut

Monday, October 20, 2008

The Rate Cut

I guess I may have left some of you hanging on the subject of the Medicare Hospice rate cut. Sorry about that, I haven’t updated, because there hasn’t been any motion.

One of the big lessons I picked up along this adventure is that Congress’ strength is inaction. Whoever is on the side of inaction usually wins when it comes to our government. In this instance, the rate cut was sent down from on high at CMS, so congress would have had to act to stop it. They did not act, so it was not stopped. The concept of congressional inaction being a strength is so accepted (and true) that congress itself uses it as a tool. The example of our times is the “Bush Tax Cuts”. If you take a peak back into the history of those tax cuts, the Democrat Party told the Republican Party that they would go along somewhat quietly if the Republicans would agree to put time limits on the tax cuts. Today, those time limits are running out. That means that congress will have to vote to reinstate them. The only thing the Democrat party has to do to get rid of those tax cuts is do nothing. There will be no bill, debate, or vote, but in the end the tax cuts will disappear. The side of any debate that must rely on congress actually doing something is at a steep disadvantage to the side that wins by congress doing nothing. The Democrats knew this when setting up the “Bush Tax Cuts” years ago, and CMS new that when they enacted a hospice rate cut without going through congress to do it.

My random civics lesson here is all to say that congress has to act to change this thing, and that isn’t something that happens easily. NHPCO has not given up, but in the meantime the rate cuts have gone into effect. Supposedly, when congress comes back after the elections they may take up this issue, but…

The lawsuit is also hanging out there somewhere. No word on where it is, where it is going, or when it may be heard. My big question at this point would be whether we could actually get the money we should have been paid if the rate cut is found to be illegal. This month I am billing less than I would have if the rate cut wouldn’t have been enacted. If the courts find that it shouldn’t have been enacted, will I get the difference paid retroactively? I know nobody knows the answer to that question, but I’d sure like to know if it is an option.

Wow, that’s quite a long post to say that I haven’t been writing about the rate cut because there hasn’t been anything to write about. Our rates have been cut. I, personally, don’t hold out much hope that it will be “uncut”, but only time will tell.

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