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State Network Council Meting Salina, KS August 29, 2011

View from Washington. State Network Council Meting Salina, KS August 29, 2011. Who am I?. Paul Muraca Regional Executive Phone: 800-981-9826 Email: pmuraca@aha.org. “Must Do” Measures. Funding the government in FY 2011 Continuing Resolutions on Appropriations

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State Network Council Meting Salina, KS August 29, 2011

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  1. View from Washington State Network Council Meting Salina, KS August 29, 2011

  2. Who am I? Paul Muraca Regional Executive Phone: 800-981-9826 Email: pmuraca@aha.org

  3. “Must Do” Measures • Funding the government in FY 2011 • Continuing Resolutions on Appropriations • Vehicle for reducing discretionary spending • Debt limit extensions • Vehicle for longer term deficit reduction • Expiring provisions – H.R. 4994 of 2010 • Taxes • Unemployment compensation benefits • Medicare physician payment cuts

  4. Where We Are • Stage 1 • Immediate budget reductionsof $917 billion...extends debt limit by $900 billion to February/March • No cuts in Medicare, Medicaid and Social Security (except fraud and abuse initiative) • No new revenues

  5. Where We Are • Stage 2 • Special bipartisan congressional committee to make additional $1.5 trillion in deficit reduction recommendations by Thanksgiving • Guaranteed up-or-down vote (and no filibuster) on recommendations if majority of panel support them by Christmas • Enforcement process…debt limit extended by another $1.5 trillion thru 2012 IF: • Recommendations of special committee adopted with resolution of disapproval; OR • Congress passes a Balanced Budget Amendment; OR • Automatic across-the-board cuts…sequester o f $1.2 billion evenly divided between defense and domestic programs: • No revenue • Medicaid exempt • Medicare and Social Security “benefits” exempt • Special rules for Medicare providers and insurers (2 percent or $137 billion over 9 years starting in 2013…$45 billion from hospitals)

  6. Special Committee Options • Medicaid…total of $100 billion • Provider taxes (assessments) • Blending rates (FMAP) • Medicare…total of $250 billion • IME ($14 billion) • Bad debt ($14-26 billion) • Rural adjustment cuts ($14-16 billion) • Post acute care services ($50 billion) • Medicare IPPS coding adjustments ($4 billion) • Expansion of IPAB

  7. Special Committee Options • Increase retirement age ($125 billion) • Means-testing ($38 billion) • Reform and increase copays for Part A & B ($110 billion) • Medigap restrictions ($53 billion) • Home health copays ($40 billion) • SNF copayments ($50 billion)

  8. Advocacy Agenda • Rural Hospital Leadership • Coalition and Caucus Reorganizing • House: Mike Thompson, D-CA and • Cathy McMorris Rogers, R-WA • Senate: Tom Harkin, IA and Pat Roberts KS • Legislative Priorities • Medicare extenders • Independent Payment Advisory Board • Provider taxes as allowable costs • Physician Supervision of Outpatient Services • 101% to CAH for Medicare Advantage • CAH Flexibility Act pending, need CBO Score • CRNA pass through and standby for CAHs

  9. Questions or Comments? Paul Muraca AHA Regional Executive 800-981-9826 pmuraca@aha.org

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