Legislative Update

The U.S. House voted 383-41 and the Senate voted 70-26 on July 15 to override a veto of H.R. 6331. The new law will halt a scheduled 10.6% cut in Medicare fee-for-service payments to physicians and will also revise Medicare requirements in sixty other areas including payments for Medicare Advantage plans, co-payments for mental health services, claims for pharmacies located in long term care facilities, incentives for electronic prescribing, and expanding access to primary care.  Increased Medicare expenditures resulting from halting the 10.6% cut ($20 billion over 5 years) will be largely offset by reductions in payments for Medicare Advantage ($14 billion over the same time period).  Provisions on other programs include an extension of Medicaid disproportionate share hospital payment adjustments, reauthorization of transitional medical assistance, extension of TANF supplemental grants, and 70% FFP for Title IV-E in the District of Columbia. The legislation also contains language that would halt a recent proposed USDHHS regulation constraining the Departmental Appeals Board (DAB).      

Tom Entrikin

Tom Entrikin is a PCG manager and former Medicaid policy specialist with the U.S. Health Care Financing Administration (HCFA), now the Centers for Medicare & Medicaid Services (CMS).