AFTER THE DUST SETTLES
What’s next in Congress after final passage of a reform bill
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.
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.