Archive for the ‘Providers’ Category

One of the most far-reaching innovations in the PPACA is the creation of an Independent Payment Advisory Board (IPAB), which will allow changes in Medicare reimbursement rules to be fast-tracked starting in 2015.  The purpose of the IPAB is to reduce the per capita rate of growth in Medicare spending.


Effective immediately, the annual market basket updates are being reduced for 15 different types of Medicare services.  The statute expressly provides, as to each of the following services that, as a result of these adjustments, a provider’s or supplier’s annual percentage increase,  may be less than zero percent in a fiscal year and thus may […]


The Health Reform law (otherwise known as the “Patient Protection and Affordable Care Act” or “PPACA”) contains numerous provisions relevant to home health agencies (“HHAs”). Reimbursement changes Perhaps most important to HHAs themselves are a number of reimbursement changes.  The HHA prospective payment system (“PPS”) will be rebased starting in 2014.  HHA rates will be […]


I have updated the following posts to focus on changes for nursing homes that are contained in the newly enacted health reform statute – Improving quality and regulatory compliance in nursing homes Making it easier for the public to understand about quality of care in nursing homes


While we all watch and wait to see if the Reconciliation Bill passes the Senate, I’m going to focus on what’s in the legislation that has been enacted so far — H.R. 3590 (formerly called the “Senate Bill”), which has passed both chambers of Congress. At the risk of  verging into the political sphere,  it […]


With the obvious intent to improve access to primary care for Medicaid recipients, the Health Care and Education Affordability Reconciliation Act of 2010 will increase Medicaid payment rates to at least the level of the Medicare rates for Evaluation & Management (E&M) codes in 2013 and 2014.  The new rates will be available to all […]


Part of the cost-savings in the House reconciliation bill would come from reducing the amount of disproportionate share hospital (“DSH”) payments Medicare makes to hospitals that serve a disproportionate number of low income people. As enacted by the Senate, the health reform bill replaces the existing DSH adjustment


I’ve added a link to the new 153-page House reconciliation bill.  See it here.  I’ve also updated the House tab and added a Table of Contents for the new bill.  Watch here for substantive commentary on its provisions.


See this post in The Hill for current status of the reconciliation bill in the House of Representatives.


The Kaiser Family Foundation has published a table that compares the provisions in the House- and Senate-passed  bills and in President Obama’s recent proposal.  You can download it here. For just the key provisions affecting Medicare program, see this link.



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