What’s next in Congress af­ter fi­nal pas­sage of a re­form bill

Modern Healthcare - - Special Report -

Physi­cian pay­ment

Im­mi­gra­tion re­form

Both the House and Se­nate are ob­li­gated to stop the dou­ble-digit cuts physi­cians face un­der the Medi­care pay­ment for­mula. Both re­form pack­ages in­clude pro­vi­sions to deal with the flawed for­mula, but those mea­sures have since been stripped in lieu of a longer-term fix. Congress has un­til late Fe­bru­ary to put some­thing to­gether to sat­isfy the physi­cian lobby— or they’ll need to pass yet an­other ex­ten­sion. The House bill is more le­nient in its treat­ment of il­le­gal im­mi­grants liv­ing in the U.S., but Congress could deal with larger re­forms in a stand-alone im­mi­gra­tion pack­age later this year. Hos­pi­tals want to see an ex­ten­sion of a fed­eral pro­gram that gives grants to hos­pi­tals that treat a high num­ber of il­le­gal im­mi­grants.

Medi­care com­mis­sion

The Se­nate bill would cre­ate the In­de­pen­dent Pay­ment Ad­vi­sory Board, which could sug­gest pay­ment rates for cer­tain provider groups. The House bill has no such pro­vi­sions. If the mea­sure stays in through the House-Se­nate ne­go­ti­a­tions, ex­pect provider groups to try to de­fang the com­mis­sion’s pow­ers.

Dis­pro­por­tion­ate-share hospi­tal pay­ments

At $20 bil­lion, the House’s bill cuts much less than the Se­nate’s pack­age—$43 bil­lion— from the fed­eral pro­gram that helps off­set the cost of treat­ing unin­sured pa­tients.

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