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What You Need To Know: The Cromnibus
What is the cromnibus?
The 1603-page cromnibus is a combination of a continuing resolution (CR) and an omnibus spending bill, hence its unique name. An omnibus typically combines a number of smaller appropriations bills into one large bill, whereas CRs are usually used to keep the government running for short periods of time while more permanent budget discussions are occurring. The current cromnibus funds most of the government through September 2015, though the CR portion funds the Department of Homeland Security through February 2015.
What is the status of the cromnibus?
Congress passed the cromnibus and President Obama signed it into law on December 16, 2014.
What does the cromnibus mean for Medicare?
The cromnibus bars the Centers for Medicare and Medicaid Services (CMS) from providing new government funds to health insurers under the Affordable Care Act’s (ACA) risk corridor program. The cromnibus also took $10 million from the Independent Payment Advisory Board (IPAB), a controversial 15-member panel put into place by the ACA tasked with implementing policies to achieve Medicare savings by monitoring spending growth.[i] No members have been nominated to IPAB yet, but the cuts ensure the group is not likely to convene in 2015.
Most notably, the cromnibus does not address the sustainable growth rate (SGR), the Medicare formula used to determine physician pay. SGR repeal has wide bi-partisan support, though Congress has historically been unable to agree on how to pay for it. The Congressional Budget Office’s most recent projections show that SGR repeal will cost $138 billion, much lower than previous estimates.[ii] By avoiding the SGR repeal in this recent budget deal, Congress is left with little time to craft a permanent solution. The current patch expires on March 31, 2015, and without a fix, doctors will see a pay cut of 21 percent.[iii] Fixing physician pay permanently is a crucial step to improving the Medicare program, but whether legislators will act in 2015 remains to be seen.





Monday, December 22, 2014