As most of Washington comes to a standstill, many physicians are scrambling to figure out how the ongoing government shutdown will affect them.
Unfortunately, if the shutdown lingers, providers may come across several issues, including a delay in Meaningful Use certifications and payments, and a potential halt in Medicare reimbursements.
So on the fifth day of the government shutdown, let’s take a look at what caused the partisan impasse, and how a cease in government services could affect physicians.
Why Did The U.S. Government Shutdown?
The Constitution bestows one central duty upon Congress: to pass spending bills that fund the government. If it fails to do this, many government functions – from supporting certain health agencies to processing passport requests – come to a halt.
Knowing this, ultra right-wing conservatives of the Republican Party, often referred to as the Tea Party, are using “the power of the purse” as a bargaining chip to stop the implementation of the Patient Protection and Affordable Care Act (PPACA).
This select group of Republicans has attached a provision to next year’s spending bill that requires a cessation in funding to the PPACA in order to fund the rest of the U.S. Federal Government.
The Democratic-led Senate staunchly rejects the provision and has stopped any federal funding from moving forward until the Republican-led House submits a “Clean Bill”, or bill without a PPACA provision, for approval.
Led by freshman Senator Ted Cruz of Texas, Tea Party members believe the President’s signature domestic policy achievement, also known as Obamacare, will damage the country immensely, and thus are willing to invoke a government shut down to get it repealed.
Federal funding will remain at an impasse until both sides can iron out a deal.
Meaningful Use Halt
As of October 1, 2013, the ONC will suspend its work in establishing standards, testing activities, managing the Certified Health IT Product List, and creating policy in the areas of privacy, security, and clinical quality measure development.
This means practices working with health IT vendors that have not yet had their systems Meaningful Use tested and certified against the 2014 Edition standards, which went into effect last week, will be stalled in meeting Stage 1 and Stage 2 Meaningful Use criteria.
Congress’ failure to pass legislation to avert a government shutdown has also forced the U.S. Department of Health & Human Services (HHS) to furlough more than half of its employees. The agency’s contingency staffing plan for operations during a government shutdown call for 52% of HHS staff or 40,512 workers to take leave without pay.
For now, Meaningful Use incentive payments are expected to continue for those providers who’ve already attested. However, there is no word yet on how long this will last.
Medicare Payments
Lacking funding, the Centers for Medicare & Medicaid Services (CMS) has furloughed 65% of its 5,994 workers but continued carrying out large parts of the Affordable Care Act, including the new health insurance exchanges that are such a huge sticking point for Republicans.
CMS has also ceased operations for healthcare fraud and abuse strike force teams while performing fewer Medicare and Medicaid provider recertification and initial surveys, potentially jeopardizing care quality for the elderly.
New Medicare enrollees also won’t be able to register for the program until government funding is appropriated.
According to HHS, the Medicare payment program will continue for a short term without disruption, but this may change if a prolonged shutdown were to stretch for more than 30 days. For now, states should also keep receiving the federal portion of funding for their Medicaid and S-CHIP programs.
At this time, it’s hard to tell what other effects the government shutdown will have on practicing physicians. But what we do know is that a conflict between political parties shouldn’t be holding the government hostage.
One can only hope our elected officials work within the framework of the government to reach a suitable conclusion and reach it soon.
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