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Federal Update

Federal Update. December 21, 2009. Congressional Activity on Reform. House Approved reform bill on November 7. Senate Vote for final passage scheduled on December 24. Process. Option 1. Option 2.

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Federal Update

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  1. Federal Update December 21, 2009

  2. Congressional Activity on Reform

  3. House Approved reform bill on November 7 Senate Vote for final passage scheduled on December 24 Process Option 1 Option 2 Alternatively, a bill approved by either chamber could be “ping-ponged” between each chamber until an identical bill is passed by both.

  4. Critical Issues for House-Senate Conference

  5. Comparing Reform Proposals

  6. Coverage Expansion

  7. Coverage Expansion–How?

  8. House: Cost = $1.052 trillion. Fully offset over ten years. * Senate: Cost = $871 billion. Fully offset over ten years. * Major Financing Components * Reflects gross cost of coverage expansions based on Congressional Budget Office (CBO) scores.

  9. House: $258 billion over ten years. Senate: $238 billion over ten years. Hospital and Health System Reductions House and Senate are generally consistent on the level of inpatient hospital cuts, with approximately $155 billion in Medicare and Medicaid reductions over ten years.

  10. Key Hospital and Health System Provisions

  11. Medicare Update Factor Reductions

  12. DSH Reductions

  13. Hospital Readmissions

  14. Hospital Value-Based Purchasing

  15. Geographic Variation

  16. Wage Index

  17. Graduate Medical Education (GME)

  18. Independent Payment Advisory Board

  19. 501(c)(3) Tax-Exempt Status

  20. 340B Drug Discount Program

  21. State Fiscal Relief

  22. Key Hospital and Health System Pilots and Demonstrations

  23. Medicare Payment Bundling

  24. Accountable Care Organizations (ACOs)

  25. Medicaid Payment Demos

  26. Center for Medicare and Medicaid Innovation

  27. Additional Provisions in House and Senate Bills

  28. Key Issue Not Fully Addressed in Reform: Medicare Physician Payment Cut

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