2010 - Medicare

Medicare  |   Medicaid   |  Coverage  |  HIT  |   Other
Item
Hospital Wage Index Floor. Starting on October 1, 2010, the provision would require application of budget neutrality associated with the effect of the imputed rural and rural floor to be applied on a national, rather than State-specific basis through a uniform, national adjustment to the area wage index.
Extends reclassifications under section 508 of the Medicare Modernization Act (P.L. 108-173) through the end of FY2010.
Urban Medicare Dependent Hospital: Requires the Secretary to conduct a study on the need for additional Medicare payments for certain urban Medicare-dependent hospitals paid under the inpatient prospective payment system.
Beginning on April 1, 2010, the Secretary shall include the average hourly wage data of hospitals whose reclassification was extended only if including such data results in a higher applicable reclassified wage index. If the wage index calculated on April 1, 2010 is lower than for the period beginning on Oct. 1, 2009, and ending on March 31, 2010, the Secretary will pay such hospital the difference by no later than Dec. 31, 2010. In addition, requires the Secretary to provide recommendations to Congress on ways to comprehensively reform the Medicare wage index system by Dec. 31, 2011. Also directs the Secretary to restore the reclassification thresholds used to determine hospital reclassifications to the percentages used in FY2009, starting in FY2011 until the first fiscal year that is on or after the date the Secretary submits the report to Congress on reforming the wage index system.
Extension of Outpatient Hold Harmless Provision. Extends the existing outpatient hold harmless provision through the end of FY2010.
Extension of LTCH MMSEA Provisions. Extends Sections 114 (c) and (d) of the Medicare, Medicaid and SCHIP Extension Act of 2007 by two years. This extends relief from the 25% rule, prohibits implementation of one-time rate adjustment and very short stay policy; extends moratorium on new LTCHs and increases in beds in existing LTCHs.
Payment Update: Hospitals (Inpatient and Outpatient), Long Term Acute Care Hospitals, Inpatient Psych. and IRFs. Requires market basket minus 0.25%. SNF, Home Health, and Hospice receive full market basket in 2010.
Extends the process allowing exceptions to limitations on medically necessary therapy (therapy cap exception) until Dec. 31, 2010.
Expansion of the Recovery Audit Contractor (RAC) Program. Not later than Dec. 31, 2010, expands RAC program to Medicaid and Medicare Parts C and D. Requires RACs to ensure that MA and PDPs implement anti-fraud plans.
Payment Adjustment for Health Care-Acquired Conditions (HACs). Prohibits Federal payments to states for Medicaid services related to HACs.
Graduate Nurse Education Demonstration Program. This provision directs the Secretary to establish a demonstration program for up to 5 eligible hospitals to increase graduate nurse education training under Medicare.
Revisions to SNF Provisions. Delays the implementation of certain SNF "RUGs-IV" payment system changes by one year (i.e., until Oct. 1, 2011).
Provide a $250 rebate to Medicare beneficiaries who reach the Part D coverage gap in 2010 and gradually eliminate the Medicare Part D coverage gap by 2020.
Ban new physician-owned hospitals in Medicare, requiring hospitals to have a provider agreement in effect by December 31; limit the growth of certain grandfathered physician-owned hospitals.
Nursing Home Five Star Quality Rating System: GAO must study.