2013 - Medicare

Medicare  |   Medicaid   |  Coverage  |  Other
Item
Payment Update: Hospitals (Inpatient and Outpatient), Inpatient Psychiatric, IRFs, and LTCHs. Requires market basket minus 0.1%.
Productivity Adjustment. Implement a full productivity adjustment for hospice providers beginning FY 2013.
Payment Update: Home Health. Requires market basket minus 1%.
Payment Update: Hospice. Requires market basket minus 0.3%.
National Pilot Program on Payment Bundling. Establishes 5-year national voluntary pilot program on payment bundling for hospitals, physicians, and post-acute care providers.
Increasing Medicaid Payment for Primary Care. Requires states to pay primary care physicians the same rate Medicare pays, and fully federally funds any additional state costs.
"Give Back" Based on Level of Insured: Hospice. For fiscal years 2013-2019 for hospice, the market basket reduction would be contingent on the level of non-elderly insured population relative to the projection of non-elderly insured at the time of enactment.
Closing Medicare Drug Coverage Gap - Begins phasing-in federal subsidies for brand-name prescriptions filled in the Medicare Part D coverage gap (reducing coinsurance from 100% in 2010 to 25% in 2020, in addition to the 50% manufacturer brand-name discount).
Establishes a national Medicare pilot program to develop and evaluate making bundled payments for acute, inpatient hospital services, physician services, outpatient hospital services, and post-acute care services for an episode of care.
Value-Based Purchasing. Creates a value-based purchasing program for Physicians, Hospitals, and Ambulatory Surgical Centers starting in FY 2013.