Hospitals
1. Standard Hospital Charges. Each hospital “shall for each year establish (and update) and make public (in accordance with guidelines developed by the Secretary) a list of the hospital’s standard charges for items and services provided by the hospital, including for diagnosis-related groups.” (Page 12)
2. Coverage of emergency services. Health insurance that covers emergency services cannot require prior authorization. (Page 16)
3. Selection of efficiency measures. Sections 1890(b)(7) and 1890A of the Social Security Act, as added by section 3014, are amended by striking “quality” each place it appears and inserting “quality and efficiency.” (Page 152)
4. Extension for the Rural Community Hospital Demonstration Program. Adds five years to the demonstration program. (Page 164)
5. Revisions of market basket adjustments. Adds “for each of fiscal years 2012 and 2013, by 0.1 percentage point” and strikes “2012,” inserting “2014.” (Page 177)
6. Modification of limitation on charges by charitable hospitals. Subparagraph (A) of section 501(r)(5) of the Internal Revenue Code of 1986, as added by section 9007 of this Act, is amended by striking “the lowest amounts charged” and inserting “the amounts generally billed.” (Page 364)
Physicians
7. Medicare Reimbursement Date Centers. These centers would “develop fee schedules and other database tools that fairly and accurately reflect market rates for medical services and the geographic differences in those rates.” (Page 23)
8. Repeal of physician payment update. There is no further explanation. Perhaps this is a repeal for one year of the 21 percent annual update or a permanent repeal of the sustainable growth rate (SGR) formula that produced it. (Page 162)
9. Innovative reimbursement methodologies. Proposes a pilot program that would “develop and implement appropriate methodologies to reimburse providers for furnishing benefits, items, or services for which payment is not otherwise covered or authorized.” (Page 196)
10. Improvements in the physician quality reporting system. These would be phased in from 2011 through 2014. This would involve complying with a maintenance of certification program run by medical boards in the various specialties. (Page 216)
11. Public reporting of performance information. By Jan. 1, 2011, HHS shall develop a Physician Compare Internet Web site with information on physicians in Medicare. Measures collected would be patient health outcomes and the functional status of patients; continuity and coordination of care and care transitions, including episodes of care and risk-adjusted resource use; efficiency; patient experience and patient, caregiver, and family engagement; safety, effectiveness, and timeliness of care; and other information as determined appropriate. (Page 226)
Independent Medicare Advisory Board
12. Expanding Scope of the board. Adds a subclause “(II) for each of 2012 and 2013, 0.1 percentage point” and strikes “2012,” inserting “2014.” (Page 180)
13. Name Change. New name would be “Independent Payment Advisory Board.” (Page 189)
Physician-owned hospitals
14. Revisions to the limitation on Medicare exception to the prohibition of certain physician referrals to hospitals. The ban on new physician-owned hospitals would start on Aug. 1, 2010, rather than Feb. 1, 2010. (Page 332)
Tort reform
15. State demonstration programs to evaluate alternatives to current medical tort litigation. Over five years, HHS will award demonstration grants to states for “the development, implementation, and evaluation of alternatives to current tort litigation.” Also: “In awarding such grants, the Secretary shall ensure the diversity of the alternatives so funded.” (Page 344)
Medical device manufacturers
16. Modification of annual fee on medical device manufacturers and importers. Strikes “2009” in subsection (a)(1), replacing it with “2010”; inserting “($3,000,000,000 after 2017)” after “$2,000,000,000.” (Page 364)
View the Manager’s Amendment.
