2011 - Medicare

Medicare  |   Medicaid   |  Coverage  |  HIT  |   Other
Item
Expanding Access to Primary Care Services and General Surgery Services. Provides primary care practitioners, as well as general surgeons practicing in health professional shortage areas, with a 10 percent Medicare payment bonus for five years.
Home Health Outlier Cap. Provider-specific annual cap of 10% of revenues on Home Health agency outlier reimbursements.
Payment Update: Hospitals. (Inpatient and Outpatient) market basket update reduced by 0.25%.
Payment Update: LTCH. Requires market basket minus 0.5%.
Payment Update: Home Health. Requires market basket minus 1%.
Payment Update: SNF and Hospice. Full market basket update
Hospice Reform. This provision would require the Secretary to update Medicare hospice claims forms and cost reports by 2011. Based on this information, the Secretary would be required to implement changes to the hospice payment system to improve payment accuracy in FY2013.
Establishment of Center for Medicare and Medicaid Innovation within CMS. Establishes within the Centers for Medicare and Medicaid Services (CMS) a Center for Medicare & Medicaid Innovation. The purpose of the Center will be to research, develop, test, and expand innovative payment and delivery arrangements (models) to improve the quality and reduce the cost of care provided to patients in each program. Appropriates $5 million from the Treasury not otherwise appropriated for the design, implementation, and evaluation of models for DY 2010; and appropriates $10 billion for Center activities over 10 years.
Geographic Variation. Includes $400 million for payments for FYs 2011 and 2012 to section 1886(d) hospitals located in counties that rank in the lowest quartile for age, sex and race adjusted per enrollee spending for Medicare Parts A and B. The payments would be proportional to each hospital's share of the sum of Medicare inpatient PPS payments for all qualifying hospitals. Includes a commitment by the Secretary to commission two Institute of Medicine studies and convene a National Summit on geographic variation, cost, access and value in health care. One study will evaluate hospital and physician geographic adjustment factors, looking at their validity as well as the methodology and data used to create them. Allowable changes will be implemented by December of 2012. The second study will examine geographic variation in the volume and intensity of health care services and recommend ways to incorporate quality and value metrics into the Medicare reimbursement system. The Secretary will also convene a National Summit on Geographic Variation, Cost, Access and Value in Health Care later this year.
Establish a new trauma center program to strengthen emergency department and trauma center capacity.
Improve access to care by increasing funding by $11 billion for community health centers and the National Health Service Corps over five years; establish new programs to support school-based health centers and nurse-managed health clinics.
Closing Medicare Drug Coverage Gap - Requires pharmaceutical manufacturers to provide a 50% discount on brand-name prescriptions filled in the Medicare Part D coverage gap beginning in 2011 and begins phasing-in federal subsidies for generic prescriptions filled in the Medicare Part D coverage gap.
Distribution of Additional Residency Slots. Directs the Secretary to redistribute residency slots that have been unfilled for the prior three cost reports and directs those slots for training of primary care physicians. Qualified hospitals would be able to request up to 75 new slots