Late last week congressional leaders from both parties announced what appear to be an agreement to eliminate the Medicare Sustainable Growth Rate (SRG) formula, what is commonly referred to as the “Medicare Doc Fix.”  It is expected that the legislation would also include an extension of some health related provisions included last year’s bill including an extension of the home visiting program, the Maternal, Infant, and Early Childhood Home Visiting (MIECHV).  It also adds in an extension of  the Children Health Insurance Program (CHIP) although at a two year extension, many advocates and some senators are holding out for a four year extension.

In a joint press release members said, “… leaders in the Senate and House introduced bipartisan, bicameral legislation to replace the broken Medicare Sustainable Growth Rate (SGR) formula with an improved payment system that rewards quality, efficiency, and innovation. The bipartisan, bicameral bill seeks to end the cycle of annual ‘Doc Fix’ crises that have created uncertainty for millions of Medicare providers and beneficiaries for over a decade and also create a system that promotes higher quality care for America’s seniors. The House and Senate Committees continue to work toward an agreement to put this plan into place as well as make reforms to strengthen Medicare and extend vital health provisions and the Children’s Health Insurance Program.”

As is the case with most legislative efforts in recent congresses agreements can falter and it’s not clear how well health extenders provisions will fare or last. Two of the biggest extensions are the priority home visiting program and the CHIP program which may be facing their best chance at extension.

In terms of home visiting it doesn’t hurt that there are two bipartisan letters in each house in support of an extension of MIECHV.   The Senate letter was led by Senator Charles Grassley (R-IA) and Senator Robert Menendez (D-NJ) and the House letter was led by Congresswoman Renee Ellmers (R-NC) and Congresswoman Lois Capps (D-CA).  The Senate letter said in part:

“Since its inception in 2010, the MIECHV program has successfully provided states with the incentives they need to invest in accountable and proven programs designed to improve the family support infrastructure.  As a result, states have partnered their home visiting programs with more accountable and comprehensive systems of care to increase efficiency and coordination across service providers… As a demonstration of the program’s tremendous national, state and local support, a letter urging an extension of the MIECHV program was recently sent to Congress with signatures from more than 750 organization and representatives from all 50 states, the territories and the District of Columbia… and added

…We further urge that the funding necessary to maintain the MIECHV program not come from other vitally important maternal and child health programs, such as the Social Services Block Grant . (emphasis added).  These programs work in concert to provide the full range of services necessary to provide children and their families with the tools they need to achieve lifelong success.”

If the agreement holds, it is not clear what day of this week it will get a vote.  The decrease in Medicare reimbursements takes effect at the end of March.  Congress is attempting to leave by week’s end for a two week spring break.