{
  "id": "R40898",
  "type": "CRS Report",
  "typeId": "REPORTS",
  "number": "R40898",
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  "source": "EveryCRSReport.com, University of North Texas Libraries Government Documents Department",
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      "id": 354623,
      "date": "2009-11-09",
      "retrieved": "2016-04-07T02:11:40.683356",
      "title": "Medicare Program Changes in H.R. 3962, Affordable Health Care for America Act ",
      "summary": "Containing scores of provisions affecting Medicare payments, payment rules, and covered benefits, H.R. 3962, as passed by the House on November 7, 2009, treats the Medicare program as both a funding source for health insurance reform and a tool to shape future changes in the way that health services are paid for and delivered. Estimates from CBO on the bill indicate that, absent interaction effects, net reductions in Medicare direct spending may approach $128.1 billion from 2010 to 2014 and $460.8 billion from 2010 to 2019. Major savings are expected from constraining Medicare\u2019s annual payment increases, linking payments for Medicare Advantage plans to fee-for-service payments, and requiring drug manufacturers to provide drug rebates for certain low-income Medicare beneficiaries. These savings would be offset by increases related to payment incentives for primary care services, expanded assistance for low-income beneficiaries enrolled in the Medicare prescription drug program, expanded coverage of preventive care services, and higher payments for various types of providers in rural areas.\nWith respect to reshaping health care delivery, H.R. 3962 would provide financial incentives to acute care and critical access hospitals to reduce potentially preventable readmissions and to improve care coordination starting in FY2012. These policies would be extended to post-acute care providers starting in FY2015. Another provision would require the Secretary to develop a detailed plan to bundle payments for post-acute care services within three years of enactment. Also, by January 1, 2011, the existing physician-hospital bundled payment demonstration would be converted to a pilot program and expanded to include post-acute services.\nH.R. 3962 would also alter Medicare payments to a range of providers, physicians, practitioners, and suppliers. Certain provisions address more systemic issues, such as increasing physician payments for preventive services. Other provisions are time-limited extensions of existing payment policies, such as two-year extensions to Section 508 hospital reclassifications, the physician geographic floor, and rural ambulance add-ons. H.R. 3962 would also change the regulation of providers. For instance, Medicare providers would be subject to enhanced screening and oversight in areas designated as high risk for fraud and abuse. Additionally, the Stark whole hospital and rural exceptions for physician-owned hospitals would be eliminated, except for those existing physician-owned hospitals that qualify for an exception.\nFinally, provisions in H.R. 3962 would improve Medicare benefits provided to individuals. For instance, the Medicare Part D coverage gap for prescription drugs (the \u201cdoughnut hole\u201d) would be eliminated, certain low-income subsidies would be amended by changing Medicare\u2019s asset test, and copayments would no longer be required for certain preventive care services.",
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    {
      "source": "University of North Texas Libraries Government Documents Department",
      "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc810680/",
      "id": "R40898_2009Nov05",
      "date": "2009-11-05",
      "retrieved": "2016-03-19T13:57:26",
      "title": "Medicare Program Changes in H.R. 3962, Affordable Health Care for America Act",
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      "type": "CRS Report",
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  "topics": [
    "Health Policy",
    "Legislative Process"
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}