government

Shutdown would have had little effect on Medicare, Medicaid claims payments

Mandatory funding and federal contingency plans meant the short-term impact on government health program operations would have been minimal.

By David Glendinning , Doug Trapp — Posted April 11, 2011

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

A late-night compromise among lawmakers on federal fiscal 2011 spending stopped a partial government shutdown from going into effect after midnight on April 8. However, the steps that federal agencies took as the deadline approached gave an indication of what might happen if the divided Congress runs into a similar stalemate over government funding levels for fiscal 2012, which will start Oct. 1.

The eleventh-hour agreement reduces federal discretionary spending by about $38.5 billion compared with fiscal 2010 levels but abandons some proposed Republican policy provisions, such as language to defund Planned Parenthood. Provisions aimed at preventing certain health reform funding will not be in the final measure but will receive a Senate vote, which is expected to fail.

The government is being kept in operation by another short-term extension until the House and Senate officially can approve the compromise later in the week of April 11. The deal is expected to pass.

Despite the impending shutdown, physicians caring for Medicare and Medicaid patients were told that they should expect their claims to be paid on time in the short term. Any closure that lasted weeks or longer, however, could have disrupted the programs, because fewer federal employees would have been available to administer them.

Funding for Medicare and Medicaid is mandatory, meaning it's not subject to annual appropriations that lapse during a shutdown. However, HHS employees who answer Medicare billing questions and process enrollment applications, among others, are paid through annual appropriations and would have been affected by the shutdown. This also is the case for private contractors who process Medicare claims.

HHS estimated that 62% of its 76,000 employees would have stopped working by the second day of a shutdown, with the rest allowed to continue, according to a Dept. of Health and Human Services contingency staffing plan posted on its website before the congressional deal on April 8. HHS agencies that handle many grants or have many workers would have been affected more quickly. For example, HHS calculated that 76% of the 5,470 employees at the Centers for Medicare & Medicaid Services would have been furloughed immediately.

However, CMS has the most mandatory funding of any HHS agency, according to the department document. Such funding would have allowed CMS to continue to support implementation of the national health reform law, programs from the 2009 economic stimulus package, state grants and demonstration projects, and the Center for Medicare and Medicaid Innovation, for example.

Any future possible shutdown might have different effects based on the status of advance federal appropriations, but in any event, a general rule of thumb would apply. Federal employees that protect life and property, including those who provide emergency medical care to patients, would continue working, according to HHS.

If Congress approves the compromise funding plan for the remainder of fiscal 2011, the next opportunity for a partial government shutdown would occur at the start of the next fiscal year on Oct. 1 if lawmakers cannot agree on a long-term funding plan or a short-term extension before that date.

House Republicans are pushing for even larger spending cuts for next year, and lawmakers are predicting more difficult negotiations in the months ahead. Another big fight could erupt over increasing the federal government's $14.3 trillion debt ceiling, which Obama administration officials expect will be necessary by May 16.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story