Last night the Senate approved a variety of Medicare and Medicaid policy extenders as part of its version ofH.R. 4213, the “Tax Extenders Act." This legislation builds on the recently-enacted “Temporary Extension Act of 2010” (H R. 4691), which extended 2009 Medicare physician fee schedule rates through the end of March 2010 (in lieu of a 21.2% across-the-board cut previously set to take effect March 1, 2010) and continued the Medicare outpatient therapy cap exceptions process through March 2010. With regard to Medicare and Medicaid policy, the Senate-approved version of H.R. 4691 would, among other things:

  • Extend the current freeze on Medicare physician fee schedule rates through September 30, 2010 (in the absence of Congressional action, the statutory sustainable growth rate formula would require a 21.2% rate cut on April 1, 2010).
  • Extend through December 31, 2010: the Medicare outpatient therapy cap exceptions process, add-on payments for Medicare mental health services, increased Medicare rates for ambulance services, the 1.0 floor on the work geographic practice cost index, the authority for independent laboratories to receive direct payments for the technical component for certain pathology services, and the hospital outpatient hold harmless provision for small rural hospitals.
  • Exempt certain pharmacies from accreditation standards for suppliers of durable medical equipment, prosthetics, orthotics, and other supplies (DMEPOS).
  • Clarify that non-hospital-based physicians and other health professionals who bill Medicare and Medicaid through a hospital may qualify for incentives for use of electronic health records.
  • Extend certain legislative relief for Medicare long-term care hospital services.
  • Continue the authority of special needs plans, cost plans, and senior housing programs to offer Medicare Advantage plans.
  • Extend through June 30, 2011 the increased federal medical assistance percentage (FMAP) funding made available to states under the American Recovery and Reinvestment Act of 2009 (ARRA).

Note that the House approved a different version of the measure in December. It is not clear at this point what the timetable or process will be for reconciling the differences between the two measures.