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Last Updated on:
07/09/08
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Congress
Approves Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act
of 2000
December
15, 2000
Congress passed a 5-year, $35 billion
Medicare and Medicaid provider relief package this evening that promises to
restore deep cuts in funding for the government health care programs attributed
to the 1997 Balanced Budget Act (BBA).
The measure will increase the nursing
component of all SNF PPS RUG categories by 16.66% over a 18-month period
beginning in April, increase the SNF PPS inflation adjustment to full
"market basket" in FY 2001, and extend the moratorium on the Part B
therapy caps through 2002. The bill will also require nursing facilities that
participate in the Medicare or Medicaid programs to begin posting nurse staffing
information on their halls beginning in 2003.
Summary
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Provision
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Medicare, Medicaid,
and SCHIP Benefits Improvement and Protection Act of 2000
(H.R. 4577)
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Increase Medicare PPS Nursing
Component
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The nursing component of each per diem
rate would be increased by 16.66% beginning on April 1, 2001 and running
through Oct. 1, 2002. GAO would also be required to complete a study of
nursing staff ratios by August 1, 2002.
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Skilled Nursing Facility (SNF)
Medicare Market Basket Update
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Would eliminate the –1% reduction in
SNF market basket update in FY2001, and set the update at market basket
minus 0.5% in FYs 2002 and 2003. Would also require the GAO to complete
a report on the adequacy of SNF Medicare payment rates by July 1, 2002.
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Redistribute Rehabilitation Category
RUG Payment Add-Ons
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Would redistribute the 20% payment
add-ons for RHC, RMC, and RMB across all 14 rehabilitation category RUGs.
Payments for RUC, RUB, RUA, RVC, RVB, RVA, RHC, RHB, RHA, RMC, RMB, RMA,
RLB, and RLA would increase by 6.7% beginning on April 1, 2001. All
other RUG groups assigned 20% payment add-ons by last year’s Balanced
Budget Refinement Act would not be affected and would continue to
receive the 20% add-ons.
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Part B Consolidated Billing
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Would repeal the impending SNF
consolidated billing requirement except for Part A covered stays and
Part B therapy services.
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Part B Therapy Caps
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Would extend the moratorium on the $1,500
per year therapy caps through 2002.
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Posting Nursing Facility Staffing
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Would require SNFs to post in a uniform,
visible place the current number of licensed and unlicensed nursing
staff directly responsible for resident care, daily and for each shift.
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Exempt Critical Access Hospitals from
SNF PPS
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Would exempt critical access hospital
swing beds from Medicare SNF PPS. Such hospitals would be paid on a
reasonable cost basis, beginning with the first cost reporting period
following the bill’s enactment.
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Medicaid ‘Upper Payment Limit’
Phase-In
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Would require HHS to issue a final
regulation establishing the Medicaid ‘upper payment limit’ by Dec.
31, 2000. The handful of states which gained approval to use ‘IGTs’
to boost their federal Medicaid match before Oct. 1, 1992 would be
granted an eight year rather than five year phase-in of the limit.
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More information on the above Act...
Click here*
to view the attachment on "Medicare, Medicaid and SCHIP Benefits
Improvement and Protection Act of 2000: HIGHLIGHTS: December 15,
2000"
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