The Medicare Payment Advisory Committee (MedPAC), the body charged with advising Congress about Medicare reimbursement issues, recommended that the hospital Medicare payment update for 2014 contain a 1 percent increase for inpatient and outpatient services.

The cost of uncompensated care to U.S. hospitals totaled $41.1 billion in 2011, according to the American Hospital Association (AHA). That was almost $2 billion more in bad debt and charity care costs than was posted in 2010.

Since passage of the Patient Protection and Affordable Care Act (PPACA), the Centers for Medicare & Medicaid Services has progressively implemented requirements that call for value-based purchasing (VBP) in all major payment systems in Medicare. With the Supreme Court’s decision in 2012 and the re-election of President Barack Obama and a Democratic Senate, the PPACA is firmly ensconced as “the law of the land” and all aspects of the VBP programs will move forward.

Another year, another dodge on the sustainable growth rate (SGR) formula. After 10 years of this, isn’t it time for Congress to acknowledge the SGR is a failure and try another approach? 

A recent appeals court decision has the potential to change the way in which pharmaceutical companies promote off-label uses of their prescription drugs, allowing for a more flexible approach. A Dec. 12, 2012, perspective in the New England Journal of Medicine questioned whether a host of other state and federal regulations can now withstand “such First Amendment scrutiny.”

Congress drew criticism for yet again delaying rather than eliminating a steep pay cut that is a perennial thorn in physicians’ side. Both the Senate and the House passed a bill that puts off a 26.5 percent cut in Medicare physician payments, but it extends only through the end of 2013.

U.S. District Judge Sterling Johnson, Jr., accepted a guilty plea by biotechnology giant Amgen for illegally introducing a misbranded drug into interstate commerce Dec. 19 in Brooklyn, N.Y. The plea is part of a settlement with the U.S., in which Amgen agreed to pay $762 million to resolve criminal and civil liability arising from its sale and promotion of certain drugs, according to the Department of Justice.

The fiscal health of nonprofit hospitals is expected to remain stable in 2013, according to Fitch Ratings, but standalone hospitals will be especially vulnerable if deep cuts in federal reimbursement occur over the year.