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CPBJ Extra Blog

Rep. Joe Pitts borrows from Obama's playbook

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If you didn't know that U.S. Rep. Joe Pitts (PA-16) was behind the SGR Band-Aid bill that abruptly delayed ICD-10 for another year, forgive yourself: It happened fast.

Really fast.

Pitts, the sole sponsor of the bill, introduced it March 26. The next day it passed the House on a hasty voice vote, which is markedly not standard procedure. If you want to understand exactly how unusual it is, you might find this helpful: GOP gripes about 'bull----' vote.

The Senate passed it by more conventional means March 31, and just like that, the deed was done. The Medicare Sustainable Growth Rate problem was patched for the 17th time, and ICD-10 was delayed until Oct. 1, 2015. Oh, and apparently the new "two-midnight" implementation that will change the observation status rules was pushed back another six months, and Medicaid Disproportionate Share Hospital cuts were postponed another year and a bunch of other things changed too.

That's a lot of action. And it reminds me of what we've seen in the implementation of Obamacare, with challenging deadlines abruptly changed after much had already been done in preparation for them.

I don't know what was the right thing to do in this case, so let's focus on what I do know.

• Providers want the two-midnight thing delayed as long as possible.

• The DSH postponement will help hospitals in states including Pennsylvania that have not expanded Medicaid.

• This was supposed to be the best chance ever to finally fix the SGR problem, and 17 Band-Aids is just ridiculous, and even with a 24 percent reimbursement cut looming if something wasn't done by March 31, the Pennsylvania Medical Society was still urging legislators to vote no on the patch and keep working on a fix.

Most of all, though, I know that delaying ICD-10 deserved serious discussion. It's a big, big deal, and as far as I can tell it has nothing to do with the SGR issue and that this last-minute change is not going to make the issue go away. Shoving it through as a rider on an unrelated bill cannot possibly have been the best way to handle it.

• • •

If you missed our live chat with The Benecon Group's Matt Kirk, you can rectify that now by reading the replay.

• • •

Without further ado, here's the reading list for this week, aka cullings of my Twitterings this week:

63% of Providers Reported No Change in Patient Volumes from ACA

Talk Turns to Penalties as Obamacare Deadline Nears

Can Obamacare be fixed? Six senators offer a plan, with an eye to the fall

Pennsylvania Auditor General to Audit State's Use of Tobacco Funds

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