2012 - Medicare

Medicare  |  Medicaid  |  Coverage  |  HIT
Item
Productivity Adjustment. Implements a full productivity adjustment for inpatient and outpatient hospital services, inpatient psychiatric facilities, inpatient rehabilitation, long term care hospital services, ESRD, and SNFs.
Payment Update: Hospitals (Inpatient and Outpatient), Inpatient Psychiatric, IRFs, and LTCHs. Requires market basket minus 0.1%.
Payment Update: Home Health. Requires market basket minus 1%.
Hospital Readmissions Reduction Program. Adjusts payments for hospitals paid under the inpatient prospective payment system based upon exceeding certain readmission thresholds.
Health Acquired Conditions Payment Policy SNFs: CMS must report to Congress on the appropriateness of applying HAC payment policy to SNFs and other providers.
Value-Based Purchasing for SNFs and Home Health Agencies: CMS must submit a plan to Congress for implementation.
Independence at Home Demonstration Program. Not later than January 1, 2012, creates a new demonstration program for chronically ill Medicare beneficiaries to test a payment incentive and service delivery system that utilizes physician and nurse practitioner directed home-based primary care teams aimed at reducing expenditures and improving health outcomes.
Community Mental Health Centers. Requires community mental health centers that provide at least 40 percent of their services to individuals not eligible for Medicare to meet new requirements for receiving Medicare billing privileges. Effective for items and services furnished on or after the first day of the first calendar quarter that is at least 12 months from the date of enactment.
Pediatric ACO Demonstration Project. Establishes a demonstration project from January 1, 2012 to December 31, 2016 for states, which would allow pediatric medical providers who meet certain criteria to be recognized as accountable care organizations (ACOs).
Medicare Accountable Care Organizations. Allows providers organized as accountable care organizations (ACOs) that voluntarily meet quality thresholds to share in the cost savings they achieve for the Medicare program. We should have the rule and comments on the regs page.
Study and Report of Effect on Veterans Health Care. No later than December 31, 2012, directs Secretary of Veterans Affairs to conduct a study on the effect (if any) of the provisions relating to the fees on branded pharmaceutical manufacturers and importers, medical device manufacturers and importers, and health insurance providers on the cost of medical care provided to veterans and veterans' access to medical devices and branded prescription drugs.