Highlights of bipartisan House plan on Medicare doctor fees

AP News
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Posted: Mar 24, 2015 5:08 PM

WASHINGTON (AP) — Highlights of the compromise released Tuesday by House Republican and Democratic leaders to permanently avoid yearly cuts in reimbursements for physicians treating Medicare patients. Cost figures were not released but are based on interviews with lawmakers, lobbyists and congressional staff:

—Medicare doctors' fees: Abolishes 1997 formula linking reimbursements to overall economic growth, which in recent years has threatened deep payment cuts that Congress has blocked. Replaced with 0.5 percent annual increases for five years and economic incentives for doctors to bill for care quality, not quantity of services.

—Community health centers: $7.2 billion over two years. Keeps funding at centers at same level as past five years under President Barack Obama's health care overhaul. Without extra money, funding drops to around $1.5 billion annually. About 1,300 centers nationwide serve millions of low-income people.

—Children's Health Insurance Program: Around $5 billion for two more years of funding for popular program serving about 8 million low-income children and pregnant women annually. Money otherwise expires Oct. 1.

—Health aid to poor: Makes two programs permanent. One helps low-income seniors from paying Medicare medical premiums. The other lets poor families keep Medicaid coverage for a year as they look for work.

—Overall cost: Around $210 billion over next 10 years.

—How financed: About two-thirds would be paid for by adding to federal deficits over coming decade. Remaining roughly $70 billion split roughly between Medicare recipients and providers.

—Recipients' costs: Individuals earning at least $134,000 annually and couples making at least $267,000 would pay higher premiums for Medicare medical and prescription drug coverage. Individuals making at least $85,000 and couples earning $170,000 already pay larger premiums. Starting in 2020, people buying new Medigap policies, which cover costs Medicare does not insure, would pay at least $147 annually out-of-pocket, compared to some policies today with no out-of-pocket expenses.

—Providers' costs: A scheduled 2018 increase in Medicare payments to hospitals of 3.2 percent will be delayed and spread over six years. IRS could impose levies of up to 100 percent on doctors and other Medicare providers with delinquent taxes, up from current 30 percent. Delays scheduled cut in payments to hospitals that serve many poor patients from 2017 to 2018 but adds an additional year of cuts in 2025. Limits 2018 increases in Medicare payments to nursing homes to 1 percent.