Fiscal Cliff Law
On December 31, The U.S. Senate passed the Fiscal Cliff bill in a 89-8 vote. On January 1, The U.S. House of Representatives passed the bill in a 257-167 vote. The bill passed, “American Tax Relief Act”, contains 26 healthcare provisions that improve our healthcare system. Most of these are extensions, revisions, and repeals of P.L. 111-148 (The Affordable Care Act).
Fiscal Cliff Health Care Provisions
The 26 health care provisions include:
SGR Fix
work graphic adjustment
increase payment for outpatient therapy services
ambulance add-on services
extension of payments for low-volumne hospitals
extension of MDH program
extension Medicare Advantage special needs programs
extension of medicare reasonable cost contracts
extension of qualifying individual program
extension of transitional medical assistance program
extension of S-CHIP Express Lane
extension of family-to family health information center
extension of indian diabetes program
coding adjustment for MS-DRGs
revisions to Medicare ESRD bundled payments
treatment of multiple service payment policies for therapy services
payment for certain radiology services
adjustment of equipment utilization rate for radiology
elimination of overpayment for diabetic supplies
removes obstacles to collection of overpayments
improves medicare advantage coding intensity adjustment
elimination of funding for Medicare Improvement Fund
Rebasing of State DSH allotments
Repeal CLASS program
creates commission on Long Term Care
Contingency fund for CO-OPs
According to The Center for Medicare and Medicaid Services and the Congressional Budget Office, the law creates $10.6 Billion in savings for healthcare. It does this specifically by adjusting
coding of MS-DRGs for IPPS hospitals (saving $10.5 billion), adjusts reimbursements for stereotactic radio surgeries (saving $40 million) and increases the utilization coding on radiology equipment from 75% to 90% (saving $80 million).
Fiscal Cliff Changes to Health Care
Listed above are the 26 health care provisions that are apart of the fiscal cliff legislation. To get a better understanding for just how these provisions will effect the industry, you can read the provisions in their entirety by clicking HERE.
