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The WVSMA has received the following update from the AMA on the reconciliation bill to the health system reform legislation:
This afternoon, the House released legislative language for the reconciliation bill that makes refinements to H.R. 3590, the health system reform bill, is to be considered soon on the floor. AMA staff are still in the process of analyzing the language, but key provisions for physicians that we have identified include:
- Improved Medicaid payment rates for primary care physicians to equal 100 percent of Medicare payment rates, including payments for office visits and immunizations, in 2013 and 2014. Provides 100 percent federal funding for the increased costs to states. (Sec 1202)
- Extended health insurance market reforms (dependent coverage up to age 26, prohibition of lifetime limits and rescissions, limitations on excessive waiting periods) to grandfathered plans six months after enactment. For group health plans, prohibits pre-existing condition exclusions in 2014, restricts annual limits six months after enactment, and prohibits them in 2014. (Sec 2301)
- Closes the Medicare prescription drug donut hole through a process beginning in 2010 and completed by 2020. (Section 1101)
- Increased federal medical assistance percentage (FMAP) paid to states for individuals newly enrolled in Medicaid as a result of the expansion of eligibility to 133% FPL (100 percent for 2014-2016, 95 percent in 2017, 94 percent in 2018, 93 percent in 2019, and 90 percent for 2020 and later years), repeal of the special FMAP for Nebraska, and changes in the formula used to calculate the amount of increased FMAP that will be paid to states that had expanded Medicaid eligibility to adults with incomes up to 100 percent FPL prior to enactment of the Act. (Sec 1201)
- Sets a 75% assumed utilization rate for expensive diagnostic imaging equipment (priced at more than $1 million/MRI, CT). (Sec 1107)
House Majority Leader Steny Hoyer (D-MD) announced on the floor today that debate will not begin until after members have had 72 hours to review the new provisions, which sets the time for the first potential floor votes at Sunday afternoon.
A detailed summary of the legislation will be posted on the AMA web site and the WVSMA site once it is completed. |
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