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Medicaid News with
John Umphress

John Umphress has spent more than two decades researching and writing about public health policy and other topics within the public policy arena, covering advocacy organizations, state and local government agencies and the Texas Legislature.

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Bill Filed to Extend Medicaid Enhancement, Fix Medicare Pay for Docs

Posted Administrator Account on 5/25/2010
 

A measure that seeks to extend enhanced Medicaid payments to states and postpone cuts in Medicare payments to physicians has been put forward by democrats in the US House of Representatives. 

Called the American Jobs and Closing Tax Loopholes Act of 2010, the bill extends enhanced Medicaid payments to states, first provided in the economic stimulus legislation, from the current expiration date of December 31 to July 1, 2011.

A number of bills aimed at extending Medicaid funding have been considered by either the House or Senate. 

The bill also delays for three years reductions in Medicare reimbursement to physicians, with a slight increase in payments each year. It also enhances payments to general and family practice physicians to encourage more of them to treat Medicare enrollees.

One provision of the bill that is drawing criticism from hospitals is a change to the so-called Medicare “72 hour rule.” Included language would prohibit retrospective billing of services unrelated to hospitalization and narrow the definition of “unrelated.”   This change is estimated to reduce payments to hospitals by $4.5 billion over the next ten years.   

The measure also extends, for the fifth time in 15 months, COBRA payment assistance to laid-off workers through the end of the year. The current extension only applies to workers who lose their jobs prior to June 1. 

In addition to concern over changes to the 72 hour rule, some members of Congress have expressed concern over the impact of the bill on the federal budget deficit. 

Other aspects of the measure that relate to health care providers include:

  • ·         Extends Section 508 hospital wage index reclassifications another year through September 30, 2011.
  • ·         Grants relief to hospitals with respect to their meeting funding requirements for defined benefit pension plans.
  • ·         Expands the existing outpatient 340B drug discount programs, covering inpatient drugs administered to those patients lacking either drug coverage or any insurance.
  • ·         Moves up by one year the implementation of the skilled nursing facility Resource Utilization Group Version 4.
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