In Washington…
After weeks of debate, a Senate provider relief package totaling $44 billion over 10 years, emerged at the end of September. The House version of a provider relief bill, which is part of the House-passed prescription drug bill provides $30 billion.
The new Senate proposal includes relief for:
Hospitals. The indirect medical payment (IME), scheduled to drop to 5.5 percent in FY 03, would be set at 6.5 percent in FY 03 and 04, and at 6 percent in FY 05. The FY 03 inpatient inflation update would be market basket minus 0.25, rather than minus 0.55. Hospital relief in the package totals $6 billion.
Physicians. Physician payment rates would be increased by 2 percent (rather than dropping by 5.7 percent). This provision is identical to the House-passed bill and, along with a few other provisions affecting physicians, is worth $12 billion.
Medicare+Choice. Minimum updates under Medicare+ Choice would rise from 2 percent to 4 percent in FY 03 and be set at 3 percent in FY 04. These provisions cost $1.3 billion.
Home health and hospice. The 15 percent home health reduction scheduled totake effect on October 1 would be eliminated. In addition, payments would be allowed under Medicare for hospice consultation services and hospices would be allowed to contract for services with other hospices under certain circumstances.
Medicaid. Roughly $5 billion would be spent on increasing the federal share of Medicaid and social services block grant expenditures.
Rural health care. A package of amendments directed at rural health care providers would cost $12 billion.
Beneficiaries. A small set of program enhancements would cost $3.5 billion.
In other legislative action...
The House of Representatives passed a medical malpractice reform bill that caps non-economic damages at $250,000 and reforms other aspects of medical liability. Unfortunately, the Senate is not expected to act on the measure before adjournment. Another patient safety bill has been introduced in the House. This one, authored by Rep. Billy Tauzin (R-LA), is yet another version of voluntary reporting and information sharing to reduce and prevent errors.