We searched for a video from Medicare.gov or the Administration on the new Medicare extension/s but could only find a Medicare YouTube video on their Physician Compare Website redesign.
We wanted to insert some images of selected parts of Title VI but that part of Blogger appears to be broken at this time.
Instead please see our notes on Title VI:
Note to our readers: If you want to get some information on how the Act will maintain and keep Medicare/Medicaid and it's costs "under control" scroll down to just past Section 643*.
Subtitle A—Medicare Extensions
Sec. 601. Medicare physician payment update.
This section is obvious and includes the provisions of the Social Security Act for the physicians section.
[42 U.S.C. 1395y]
(a) Notwithstanding any other provision of this title, no payment may be made
under part A or part B for any expenses incurred for items or ...
Part E—Miscellaneous Provisions.
DEFINITIONS OF SERVICES, INSTITUTIONS, ETC. Sec. 1861. [42 U.S.C. 1395x] For purposes of this title— ...
Sec. 602. Work geographic adjustment.
Sec. 603. Payment for outpatient therapy services.
Outpatient therapy payments appear to be extended at least until "December 31, 2013".
Sec. 604. Ambulance add-on payments. This section also covers air ambulances. It is extended until "January 1, 2014".
Sec. 605. Extension of Medicare inpatient hospital payment
adjustment for low-volume hospitals. This section is quite brief and only mentions extending it to "2013/2014".
Sec. 606. Extension of the Medicare-dependent hospital (MDH)
program. Defines how hospitals are paid and hospitals may still "decline reclassification (?)". Extended through FY 2013.
Sec. 607. Extension for specialized Medicare Advantage plans
for special needs individuals. For special needs patients who require special care - this is extended through "2015". No further clarification is provided by the Act.
Sec. 608. Extension of Medicare reasonable cost contracts.
Sec. 609. Performance improvement. This is one part of the Act that requires Medicare data review (parts A, B and D), strategy development and updates, study and reporting by the GAO and more for the performance improvement. This appears to be a mechanism to control costs. See also Section 643.
Sec. 610. Extension of funding outreach and assistance for
low-income programs. This should cover the elderly and disabled through "Fiscal Year 2013". It appears to be capped at $7.5m and $5m only.
Subtitle B—Other Health Extensions
Sec. 621. Extension of the qualifying individual (QI)
program.
Sec. 622. Extension of Transitional Medical Assistance
(TMA).
Sec. 623. Extension of Medicaid and CHIP Express Lane
option.
Sec. 624. Extension of family-to-family health information
centers.
Sec. 625. Extension of Special Diabetes Program for Type I
diabetes and for Indians.
Subtitle C—Other Health Provisions
Sec. 631. IPPS documentation and coding adjustment for
implementation of MS-
DRGs. Err, this section contains a piece on“Abstinence Education”? Was this a part of the deal with portions of the GOP?
Sec. 632. Revisions to the Medicare ESRD bundled payment
system to reflect findings in the GAO report.
Sec. 633. Treatment of multiple service payment policies for
therapy services.
Sec. 634. Payment for certain radiology services furnished
under the Medicare hospital outpatient department prospective payment system.
Sec. 635. Adjustment of equipment utilization rate for
advanced imaging services.
Sec. 636. Medicare payment of competitive prices for
diabetic supplies and elimination of overpayment for diabetic supplies.
Sec. 637. Medicare payment adjustment for non-emergency
ambulance transports
for ESRD beneficiaries.
Sec. 638. Removing obstacles to collection of overpayments.
Sec. 639. Medicare advantage coding intensity adjustment.
Sec. 640. Elimination of all funding for the Medicare
Improvement Fund.
Sec. 641. Rebasing of State DSH allotments.
Sec. 642. Repeal of
CLASS program. (Ref: http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act)
(And http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf)
The Act is 906 pages long. Rescinded
section of the Act: “(5) The initial net savings
generated by the Community
Living
Assistance Services and Supports (CLASS) program are
necessary
to ensure the long-term solvency of that program.
(b)
SENSE OF THE SENATE.—It is the sense of the Senate
that—
(1)
the additional surplus in the Social Security Trust
Fund
generated by this Act should be reserved for Social Security
and
not spent in this Act for other purposes; and
(2)
the net savings generated by the CLASS program should
be
reserved for the CLASS program and not spent in this
Act
for other purposes.”
Sec. 643. Commission on Long-Term Care. “(a) ESTABLISHMENT.—There is established a
commission to be
known as the Commission on Long-Term Care (referred to in
this
section as the ‘‘Commission’’).
*Note to our readers: This is a very interesting portion of the Act. It sets up a Commission, a Quorum, a Chairman, a Vice-Chairman, Hearings and "other activities". This appears to be a mechanism (new) to maintain a working Medicare/Medicaid system and with cost and other controls for review. We hope that this process will be "transparent" - though we expect it to be rather boring. See also Section 609.
(b) DUTIES.—
(1) IN GENERAL.—The Commission shall develop a plan
for the establishment, implementation, and financing of a
comprehensive, coordinated, and high-quality system that ensures
the availability of long-term services and supports for
individuals in need of such services and supports, including elderly
individuals, individuals with substantial cognitive or
functional
limitations, other individuals who require assistance to
perform activities of daily living, and individuals desiring to plan for
future long-term care needs.
(2) EXISTING HEALTH CARE PROGRAMS.—For purposes of
developing the plan described in paragraph (1), the
Commission
shall provide recommendations for—
(A) addressing the interaction of a long-term services
and support system with existing programs for long-term
services and supports, including the Medicare program
under title XVIII of the Social Security Act (42 U.S.C.
1395 et seq.) and the Medicaid program under title XIX
of the Social Security Act (42 U.S.C. 1396 et seq.), and
private long-term care insurance;
(B) improvements to such health care programs that
are necessary for ensuring the availability of long-term
services and supports; and
(C) issues related to workers who provide long-term
services and supports, including—
(i) whether the number of such workers is adequate to
provide long-term services and supports to
individuals with long-term care needs;
(ii) workforce development necessary to deliver
high-quality services to such individuals;
(iii) development of entities that have the capacity
to serve as employers and fiscal agents for workers
who provide long-term services and supports in the
homes of such individuals; and
(iv) addressing gaps in Federal and State infrastructure
that prevent delivery of high-quality long
term services and supports to such individuals. (3) ADDITIONAL CONSIDERATIONS.—For purposes
of developing the plan described in paragraph (1), the Commission
shall take into account projected demographic changes and
trends in the population of the United States, as well as
the
potential for development of new technologies, delivery
systems,
or other mechanisms to improve the availability and quality
of long-term services and supports.
(4) CONSULTATION.—For purposes of developing the plan
described in paragraph (1), the Commission shall consult
with
the Medicare Payment Advisory Commission, the Medicaid and
CHIP Payment and Access Commission, the National Council
on Disability, and relevant consumer groups.
(c) MEMBERSHIP.—
(1) IN GENERAL.—The Commission shall be composed of
15 members, to be appointed not later than 30 days after
the date of enactment of this Act, as follows:
(A) The President of the United States shall appoint
3 members.
(B) The majority leader of the Senate shall appoint
3 members.
(C) The minority leader of the Senate shall appoint
3 members.
(D) The Speaker of the House of Representatives shall
appoint 3 members.
(E) The minority leader of the House of Representatives
shall appoint 3 members.
(2) REPRESENTATION.—The membership of the Commission shall
include individuals who— (A) represent the interests of—
(i) consumers of long-term services and supports
and related insurance products, as well as their
representatives;
(ii) older adults;
(iii) individuals with cognitive or functional limitations;
(iv) family caregivers for individuals described in
clause (i), (ii), or (iii);
(v) the health care workforce who directly provide
long-term services and supports;
(vi) private long-term care insurance providers;
(vii) employers;
(viii) State insurance departments; and
(ix) State Medicaid agencies;
(B) have demonstrated experience in dealing with
issues related to long-term services and supports, health
care policy, and public and private insurance; and
(C) represent the health care interests and needs of
a variety of geographic areas and demographic groups.
(3) CHAIRMAN AND VICE-CHAIRMAN.—The Commission shall
elect a chairman and vice chairman from among its members.
(4) VACANCIES.—Any vacancy in the membership of the
Commission shall be filled in the manner in which the
original
appointment was made and shall not affect the power of the
remaining members to execute the duties of the Commission.
(5) QUORUM.—A quorum shall consist of 8 members of
the Commission, except that 4 members may conduct a hearing
under subsection (e)(1).
(6) MEETINGS.—The Commission shall meet at the call
of its chairman or a majority of its members.
(7) COMPENSATION AND REIMBURSEMENT OF EXPENSES.—
(A) IN GENERAL.—To enable the Commission to exercise
its powers, functions, and duties, there are authorized to
be disbursed by the Senate the actual and necessary
expenses of the Commission approved by the chairman
and vice chairman, subject to subparagraph (B) and the
rules and regulations of the Senate.
(B) MEMBERS.—Members of the Commission are not
entitled to receive compensation for service on the
Commission. Members may be reimbursed for travel, subsistence,
and other necessary expenses incurred in carrying out the
duties of the Commission.
(d) STAFF AND ETHICAL STANDARDS.—
(1) STAFF.—The chairman and vice chairman of the
Commission may jointly appoint and fix the compensation of
staff as they deem necessary, within the guidelines for
employees of the Senate and following all applicable rules
and
employment requirements of the Senate.
(2) ETHICAL STANDARDS.—Members of the Commission who serve
in the House of Representatives shall be governed by
the ethics rules and requirements of the House. Members of
the Senate who serve on the Commission and staff of the
Commission shall comply with the ethics rules of the Senate.
(e) POWERS.—
(1) HEARINGS AND OTHER ACTIVITIES.—For the purpose of
carrying out its duties, the Commission may hold such
hearings…”
Sec. 644. Consumer Operated and Oriented Plan program
contingency fund.
That's about all the time we have to cover Medicare and other health care provisions and extensions of Act H. R. 8 at this time.
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