Legislative Update on Extenders and 1099
As you may have seen, Sen. Baucus introduced his latest version of tax extenders legislation yesterday. A summary of health related provisions follows below; however, all these provisions have been included in prior versions of the extenders package. The Medicare SGR “doc fix” and extension of Medicaid “stimulus” funding were removed, both provisions having been signed into law earlier this year. The remainders consist of several Medicare-related provisions, as well as a variety of tweaks of and changes to the health care law. It also includes a $400 million provision (Section 510) adjusting Medicare fee schedule localities in California, which some may view as a legislative earmark.
While Sen. Baucus sought unanimous consent to pass the legislation yesterday, Republicans objected, due to both a lack of time to review the bill and lack of opportunity to offer amendments. Following that exchange, Sen. Baucus told CongressDaily he expected consideration to take place during a lame duck session. As a friendly reminder, the Medicare “doc fix” (which is not included in the current extenders package) expires at the end of November; physicians in Medicare face a 23 percent pay cut on December 1, followed by an additional 6.5 percent reduction on January 1.
Separately, Politico reports this morning that the Democrat leadership in the other body is preparing for another vote on a stand-alone 1099 measure, potentially next week. Apparently the bill will fully repeal the 1099 reporting requirement included in Section 9006 of the health care law – something which Bill Nelson’s amendment, voted on in the Senate this week, did not do. However, unlike Republican efforts in both the House and Senate to repeal the 1099 reporting requirement, the latest Democrat initiative would paid for by raising other taxes on business. The article quotes one Democrat staffer as saying this latest 1099 repeal effort is designed “to put Republicans into a corner” by including a new tax on carried interest as a pay-for.
340B Program: Adds inpatient drugs to the 340B outpatient discount program, and maintains childrens hospitals’ ability to participate in the 340B discount program with respect to orphan drugs.
Health Law Clarifications: Repeals the health law’s delay of the revised skilled nursing facility prospective payment system, as well as the law’s extension of reasonable cost payments for certain laboratory services. Repeals section 6502 of the law, which requires states to exclude certain providers from Medicaid and SCHIP. Includes other clarifying amendments with respect to drafting errors in the health care law.
Other Provisions: Extends for an additional year (through September 30, 2011) the Section 508 hospital reclassification program, at a cost of $300 million over five and ten years. Provides $175 million in mandatory appropriations to CMS to implement the act’s provisions. Includes clarifying provisions regarding eligibility for Medicaid health IT funding provided in the “stimulus.” Provides $400 million to California to adjust Medicare fee schedule localities, and includes clarifying language preventing Medicare providers from un-bundling reimbursement requests. Includes language regarding affiliated hospitals and language in the health care law surrounding distribution of medical residency positions.