Medicare Quality Improvement Act

Medicare part B physician payment provisions of the omnibus appropriations bill HJR 2. S. 1054, Jobs and Growth Tax Relief Reconciliation Act of 2003, introduced by Senator Grassley. Specifically, amendment No. 594, To amend title XVIII of the Social Security Act to enhance beneficiary access to quality health care services in rural areas under the Medicare program. All provisions improving the reimbursement of physician in rural areas. Save this template.Issue Template Text BUD budget/appropriations OrS. 1, Prescription Drug and Medicare Improvement Act of 2003'introduced by Senators Grassley and Baucus. Provisions calling for a statutory increase in Medicare physician payments for 2004-2005; provisions equalizing payments for physicians in rural areas for 2004?2007 by implementing a floor of 1.0 for the geographic adjustment of physician work, and practice expense. Incentive payments for physicians in underserved areas. “Medicare Equity” concepts developed by Senate Finance Committee taking incremental steps towards Medicare reform, including restructuring CMS, improving Medicare+Choice, increasing the number of plans in rural areas, and easing payment inequities between urban and rural providers. Regulatory reform of CMS. Specific provisions include: Sec. 108, Protecting seniors with cancer; Sec. 203, Payments to MedicareAdvantage organizations; Sec. 421, Establishment of floor on geographic adjustments of payments for physicians' services; Sec. 422, Medicare incentive payment program improvements; Sec. 431, Application of coinsurance and deductible for clinical diagnostic laboratory tests. Sec. 432, Basing Medicare payments for covered outpatient drugs on market prices; Sec. 441, Medicare health care quality demonstration programs. Sec. 442, Medicare complex clinical care management payment demonstration. Sec. 443, Medicare fee-for-service care coordination demonstration program; Sec. 444, GAO study of geographic differences in payments for physicians' services; Sec. 441, Medicare health care quality demonstration programs. Sec. 442, Medicare complex clinical care management payment demonstration. Sec. 443, Medicare fee-for-service care coordination demonstration program; Sec. 444, GAO study of geographic differences in payments for physicians' services; Sec. 453, Clarifications to certain exceptions to Medicare limits on physician referrals; Sec. 455, MEDPAC study on Medicare payments and efficiencies in the health care system; Sec. 464, Sense of the Senate concerning Medicare payment update for physicians and other health professionals; Sec. 504. Streamlining and simplification of Medicare regulations. HR 2473, Medicare Prescription Drug and Modernization Act of 2003, introduced by Rep. Bill Thomas, to amend title XVIII of the Social Security Act to provide for a voluntary program for prescription drug coverage under the Medicare Program, to modernize the Medicare Program. HR 1, Medicare Prescription Drug and Modernization Act of 2003, introduced by Reps. Thomas, Tauzin, Johnson and Bilirakis, provisions establishing a 1.5% Medicare Part B conversion factor update in 2004 and 2005; provisions instructing GAO to examine the impact of the geographic adjustment factor on physician payments under the Medicare physician fee schedule; increasing Medicare+Choice payments; Full reimbursement of Medicare Allowed Costs under Medicare Part B; preservation of floor payments in rural areas under Medicare+Choice. Demonstration programs under Medicare to increase beneficiary and plan participation in the Medicare +Choice Program. Specific provisions include: Sec. 241. Application of FEHBP-style competitive reform beginning in 2010. Sec. 303. Competitive acquisition of covered outpatient drugs and biologicals. Sec. 413. GAO study of geographic differences in payments for physicians' services; Sec. 417, Medicare incentive payment program improvements for physician scarcity; Sec. 505. MedPAC report on specialty hospitals; Sec. 601 Revision of updates for physicians' services; Sec. 602. Studies on access to physicians' services; Sec. 603. MedPAC report on payment for physicians' services; Sec. 605. Establishment of floor on work geographic adjustment; Sec. 611. Coverage of an initial preventive physical examination; Sec. 625. Adjustment to payments for services furnished in ambulatory surgical centers; Sec. 941. Policy development regarding evaluation and management (E & M) documentation guidelines. Federal reimbursement of telehealth grant programs through Medicaid and Medicare. Modification of Medicare physician fee schedule geographic work adjustor. HR 33, the Rural Equity Payment Index Reform Act (REPAIR) introduced by Rep. Doug Bereuter, would lessen the disparity in Medicare physician payment that currently exists between urban and rural areas. S. 881, by Bingaman Rural Equity Payment Index Reform Act of 2003 to establish a minimum geographic cost-of-practice index value for physicians' services furnished under the medicare program S. 36, Feingold legislation to eliminate the geographic physician work adjustment factor from the geographic indices used to adjust payments under the Medicare physician fee schedule. HR 810, Medicare Regulatory and Contracting Reform Act of 2003, introduced by Rep. Nancy Johnson (Sec. 501) Prohibits the Secretary from implementing any new documentation guidelines for, or clinical examples of, evaluation and management physician services under Medicare unless the Secretary: has developed the guidelines in collaboration with practicing physicians (including both generalists and specialists) and provided for an assessment of the proposed guidelines by the physician community; has established a program to educate physicians on the use of such guidelines. Requires the Secretary to make changes to the manner in which existing evaluation and management documentation guidelines are implemented to reduce paperwork burdens on physicians. S. 1148 Medicare Quality Improvement Act' by Jeffords authorizing the Centers for Medicare and Medicaid Services to conduct research demonstrations to examine health delivery factors that encourage the delivery of improved quality in patient care. HR 1539, the Hospital Investment Act of 2003, introduced by Rep. G. Kleczka, amends title XVIII (Medicare) of the Social Security Act to limit the hospital ownership exception to physician self-referral restrictions to interests purchased on terms generally available to the public HR 1622, the Quality Cancer Care Preservation Act, introduced by Rep. Charles Norwood and Lois Capps, to amend title XVIII of the Social Security Act and otherwise revise the Medicare Program to reform the method of paying for covered drugs, drug administration services, and chemotherapy support services. HR 2161, the Prescription Value Act introduced by Rep. Doug Bereuter, which would require the Agency for Healthcare Research and Quality (AHRQ) to collect and assess scientific evidence regarding the value of prescription drugs frequently used by Medicare or Medicaid beneficiaries. On September 27, 2002 the Centers for Medicare and Medicaid Services published a notice in the Federal Register informing interested parties of an opportunity to submit proposals for participation in the Medicare Physician Group Practice Demonstration (PGP) project to test a hybrid payment methodology that combines Medicare fee-for-service payments with a bonus pool derived from savings achieved by improvements in patient care management. Marshfield Clinic submitted a proposal for this demonstration and remains in contact with the Centers for Medicare and Medicaid Services regarding the proposal. HR 883 Medicare Laboratory Services Access Act of 2003 introduced by Rep English, Phil - Amends title XVIII (Medicare) of the Social Security Act (SSA) to specify as $5.42 for 2004, adjusted for inflation in each subsequent year, the nominal fee for collecting specimens for clinical diagnostic laboratory tests under Medicare. Oppose limits on the laboratory CPI update.

Client expense: $148,062 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Council of Economic Advisers (CEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE