President Bush Signs Law To Revise Medicare Inpatient Hospital Reimbursement Rule, Extend Health Care Programs

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Public Health
Article Date: 02 Oct 2007 - 12:00 PDT

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President Bush on Saturday signed into law a bill (HR 3668) that will revise a provision in a CMS rule related to Medicare inpatient hospital reimbursements, CQ HealthBeat reports. The "behavioral offset" provision -- which addresses the expectation that hospitals will "upcode," or bill Medicare for services reimbursed at higher rates -- would have reduced Medicare inpatient hospital reimbursements by $20.3 billion over five years, according to hospital groups.

The law, which will reduce the offsets by half to 0.6% in 2008 and to 0.9% in 2009 but will not address the offset in 2010, will restore $2.5 billion in Medicare inpatient hospital reimbursements over two years and $7 billion over five years.

The law, which both the House and Senate passed last week by voice vote, also will extend by three months two federal programs that help low-income U.S. residents obtain health insurance and a federal abstinence education program, all of which would have expired on Sept. 30.

In addition, the law will delay by six months a CMS rule that would have required physicians to write prescriptions for Medicaid beneficiaries on tamper-resistant pads (Carey, CQ HealthBeat, 9/28). According to pharmacy groups, many physicians could not obtain tamper-resistant pads by Oct. 1, the date that the rule would have taken effect. As a result, the groups said that many pharmacists would have had to deny prescriptions to Medicaid beneficiaries or fill prescriptions improperly with the possibility of having to return reimbursements (CongressDaily, 9/28).

Other Provisions
The law also will extend a Medicaid asset verification program through 2012 and will provide an additional $340 million over five years for a Medicare program that provides bonus payments to physicians who report on a set of quality measures.

In addition, the law will extend a federal program that pays Medicare Part B premiums for low-income beneficiaries and will extend the Transitional Medical Assistance program, which allows families who move from welfare into the work force to retain Medicaid coverage for up to four months (CQ HealthBeat, 9/28).

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