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 Collection: Congressional Research Service Reports
Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System

Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System

Date: August 2, 2012
Creator: Hahn, Jim & Mulvey, Janemarie
Description: This report discusses the Sustainable Growth Rate (SGR), which is the statutory method for determining the annual updates to the Medicare physician fee schedule. The SGR system was established because of the concern that the Medicare fee schedule itself would not adequately constrain overall increases in spending for physicians’ services.
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Health Care and Markets

Health Care and Markets

Date: January 5, 2007
Creator: Austin, D. Andrew & Government and Finance Division
Description: Health care spending is one of the most rapidly growing portions of the federal budget. Projections suggest if the rapid growth in health care costs is not curtailed, governments at all levels will face an uncomfortable choice between significant cuts in other spending priorities or major tax increases. This report examines the economic justification for government intervention and involvement in health care markets.
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Federal Drug Price Negotiation: Implications for Medicare Part D

Federal Drug Price Negotiation: Implications for Medicare Part D

Date: April 19, 2007
Creator: Hahn, Jim
Description: This report discusses what it means for the federal government to “negotiate” drug prices under existing public programs, the arguments for and against such activities, and some implications for the pharmaceutical industry, Medicare beneficiaries, and others if similar federal involvement were to occur on behalf of the Medicare Part D program.
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Centers for Medicare & Medicaid Services: President’s FY2013 Budget

Centers for Medicare & Medicaid Services: President’s FY2013 Budget

Date: April 9, 2012
Creator: Mitchell, Alison & Paulette, Morgan C.
Description: This report summarizes the President's budget estimates for each section of the CMS budget. Then, for each legislative proposal included in the President's budget, this report provides a description of current law and the President's proposal. The explanations of the President's legislative proposals are grouped by the following program areas: Medicare, Medicaid, program integrity, and health insurance programs.
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Overview of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003

Overview of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003

Date: December 6, 2004
Creator: O'Sullivan, Jennifer; Chaikind, Hinda; Tilson, Sibyl; Boulanger, Jennifer & Morgan, Paulette
Description: This report examines the the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, which creates a prescription drug benefit for Medicare beneficiaries and establishes a new Medicare Advantage program to replace the current Medicare+Choice program.
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The Affordable Care Act and Small Business: Economic Issues

The Affordable Care Act and Small Business: Economic Issues

Date: February 25, 2014
Creator: Lowry, Sean & Gravelle, Jane G.
Description: This report explains how employer-sponsored insurance can be used to address concerns about health insurance coverage and cost. Then, it summarizes the three ACA provisions most relevant to small businesses. Also, it analyzes these provisions for their potential effects on small businesses. Last, this report presents several approaches that could address some concerns associated with these provisions (particularly the employer penalty).
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Treating Ebola Patients in the United States: Health Care Delivery Implications

Treating Ebola Patients in the United States: Health Care Delivery Implications

Date: November 4, 2014
Creator: Sarata, Amanda K.
Description: This report discusses the recent response to Ebola patients in the United States. While the U.S. health care system has the resources to effectively identify and treat Ebola cases, a situation that is novel, emergent, and resource-intensive may test the system's ability to effectively mobilize those resources.
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Extensively Drug-Resistant Tuberculosis (XDR-TB): Emerging Public Health Threats and Quarantine and Isolation

Extensively Drug-Resistant Tuberculosis (XDR-TB): Emerging Public Health Threats and Quarantine and Isolation

Date: November 26, 2010
Creator: Swendiman, Kathleen S. & Jones, Nancy Lee
Description: This report the international saga of Andrew Speaker, a traveler thought to have XDR-TB, a drug-resistant form of tuberculosis, placed a spotlight on existing mechanisms to contain contagious disease threats and raised numerous legal and public health issues. It also discusses the application of various public health measures available to contain an emerging public health threat posed by an individual who ignores medical advice and attempts to board an airplane or take other forms of public transportation.
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Congress Faces Calls to Address Expiring ACA Appropriations

Congress Faces Calls to Address Expiring ACA Appropriations

Date: November 25, 2014
Creator: Redhead, C. Stephen & Heisler, Elayne J.
Description: This report discusses the Affordable Care Act (ACA), enacted in March 2010, which appropriated billions of dollars of mandatory funds to support grant programs and other activities authorized by the law.
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H.R. 2: The Children's Health Insurance Program Reauthorization Act of 2009

H.R. 2: The Children's Health Insurance Program Reauthorization Act of 2009

Date: January 14, 2009
Creator: Baumrucker, Evelyne P.; Herz, Elicia J.; Peterson, Chris L.; Tilson, Sibyl & Gravelle, Jane G.
Description: This report summarizes changes to current law across the major provisions of H.R. 2 that would occur if The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) were enacted.
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Beverage Industry Pledges to Reduce Americans' Drink Calories

Beverage Industry Pledges to Reduce Americans' Drink Calories

Date: October 6, 2014
Creator: Dabrowska, Agata
Description: This report briefly covers recent initiatives by leading beverage companies to curb the obesity epidemic.
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Medicare: Part B Premiums

Medicare: Part B Premiums

Date: December 29, 2008
Creator: Hahn, Jim
Description: This report examines the history of the Medicare Part B Premium. The report considers issues including the changing factors that go into determining the premium. The report also discusses the comparative cost adjustment program, the Part B deductible, and the Part A premium.
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Ebola: Selected Legal Issues

Ebola: Selected Legal Issues

Date: December 16, 2014
Creator: Cole, Jared P.; Perry, Rodney M.; Dolan, Alissa M.; Shimabukuro, Jon O.; Garcia, Michael J.; Smith, Jane M. et al.
Description: Several West African countries are currently grappling with an unprecedented outbreak of Ebola virus disease (EVD). Here in the United States, where Ebola is not endemic, a handful of EVD cases have been diagnosed, and domestic transmission of the virus has occurred in only two cases to date. This report provides a brief overview of selected legal issues regarding measures to prevent transmission of Ebola virus and the civil rights of individuals affected by the disease.
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The Affordable Care Act and Small Business: Economic Issues

The Affordable Care Act and Small Business: Economic Issues

Date: January 15, 2015
Creator: Lowry, Sean & Gravelle, Jane G.
Description: This report explains how employer-sponsored insurance can be used to address concerns about health insurance coverage and cost. Then, it summarizes the three Affordable Care Act (ACA) provisions most relevant to small businesses. Also, it analyzes these provisions for their potential effects on small businesses. Last, this report presents several approaches that could address some concerns associated with these provisions (particularly the employer penalty).
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Health Coverage Tax Credit

Health Coverage Tax Credit

Date: April 2, 2015
Creator: Fernandez, Bernadette
Description: The report describes the expired eligibility criteria, as well as the types of health insurance to which the tax credit may have been applied. It discusses past federal and state roles in administering the HCTC program, and it summarizes analyses on the credit's effectiveness in reaching targeted populations and related equity and efficiency issues. In addition, the report includes a short discussion of relevant current law and summarizes statutory history of the HCTC program.
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Health Insurance Premium Credits in the Patient Protection and Affordable Care Act (ACA) in 2015

Health Insurance Premium Credits in the Patient Protection and Affordable Care Act (ACA) in 2015

Date: March 18, 2015
Creator: Fernandez, Bernadette
Description: This report describes the eligibility criteria applicable to the premium tax credits and cost-sharing subsidies, and the calculation method for the credit and subsidy amounts. It also highlights selected issues addressed in the final regulation and guidance on premium credits and indicates the status of implementation, where relevant data is available.
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Private Health Insurance Provisions of S. 1796, America's Healthy Future Act of 2009

Private Health Insurance Provisions of S. 1796, America's Healthy Future Act of 2009

Date: November 16, 2009
Creator: Fernandez, Bernadette; Chaikind, Hinda; Peterson, Chris L.; Newsom, Mark & Mulvey, Janemarie
Description: This report summarizes key provisions affecting private health insurance in S. 1796, America's Healthy Future Act of 2009, as ordered reported by the Senate Committee on Finance on October 19, 2009.
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Medicaid and Children's Health Insurance Program (CHIP) Provisions in Affordable Health Care for America Act (H.R. 3962)

Medicaid and Children's Health Insurance Program (CHIP) Provisions in Affordable Health Care for America Act (H.R. 3962)

Date: November 10, 2009
Creator: Herz, Elicia J.; Baumrucker, Evelyne P.; Binder, Cliff; Stone, Julie; Heisler, Elayne J. & Hoffman, Geoffrey
Description: This report summarizes the major provisions affecting Medicaid and CHIP in H.R. 3962 (as passed), including modifications made by the manager's amendment. The report focuses on provisions in Division B, Title VII--Medicaid and CHIP, plus selected provisions in Title IX--Miscellaneous Provisions. It also describes selected sections of Titles I and II of Division D, the Indian Health Care Improvement Act Amendments of 2009, related to improving access to Medicaid and CHIP for American Indians and Alaskan Natives.
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A Comparative Analysis of Private Health Insurance Provisions of H.R. 3962 and S.Amdt. 2786 to H.R. 3590

A Comparative Analysis of Private Health Insurance Provisions of H.R. 3962 and S.Amdt. 2786 to H.R. 3590

Date: December 16, 2009
Creator: Peterson, Chris L.
Description: This report compares many of the private health insurance provisions of H.R. 3962 and the Senate Amendment. For each of the major private health insurance reforms, the report first gives a narrative description of the context and current law, then describes where H.R. 3962 and the Senate Amendment make similar reforms and how their approaches differ.
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Catastrophic Health Insurance: Comparison of the Major Provisions of the "Medicare Catastrophic Protection Act of 1987" (H.R. 2470, as passed by the House July 22, 1987) and the "Medicare Catastrophic Loss Prevention Act of 1987" (S. 1127, as passed by the Senate Finance Committee, July 27, 1987)

Catastrophic Health Insurance: Comparison of the Major Provisions of the "Medicare Catastrophic Protection Act of 1987" (H.R. 2470, as passed by the House July 22, 1987) and the "Medicare Catastrophic Loss Prevention Act of 1987" (S. 1127, as passed by the Senate Finance Committee, July 27, 1987)

Date: August 5, 1987
Creator: O'Sullivan, Jennifer
Description: Catastrophic Health Insurance: Comparison of the Major Provisions of the “Medicare Catastrophic Protection Act of 1987” (H.R. 2470, as passed by t h e House July 22, 1987) and the "MEDICARE CATASTROPHIC LOSS PREVENTION ACT OF 1987" (S. 1127, as reported by the S e n a t e Finance Committee, July 27, 1987)
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Medicaid Financing and Expenditures

Medicaid Financing and Expenditures

Date: July 30, 2012
Creator: Mitchell, Alison
Description: This report provides an overview of Medicaid’s financing structure, including both federal and state financing issues. The Medicaid expenditures section of the report discusses economic factors affecting Medicaid, state variability in spending, and projected program spending. Other issues that are examined include congressional proposals to turn Medicaid into a block grant program, federal deficit reduction proposals affecting Medicaid, and state fiscal conditions affecting Medicaid financing and services.
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Medicaid Regulatory Issues

Medicaid Regulatory Issues

Date: November 26, 2008
Creator: Herz, Elicia J. & Burrows, Vanessa K.
Description: This report provides a summary of seven proposed and final rules affecting the Medicaid program that were issued by the Bush Administration during 2007 and 2008. Six of the seven rules are currently under a congressional moratorium on further administrative action until April 1, 2009. A description of possible administrative and legislative actions to modify these rules, which could be taken by the next administration or the 111th Congress, is also provided.
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Transitional Medical Assistance (TMA) Under Medicaid

Transitional Medical Assistance (TMA) Under Medicaid

Date: June 30, 2004
Creator: Grady, April
Description: None
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Budget Reconciliation FY2006: Provisions Affecting the Medicaid Federal Medical Assistance Percentage (FMAP)

Budget Reconciliation FY2006: Provisions Affecting the Medicaid Federal Medical Assistance Percentage (FMAP)

Date: November 28, 2005
Creator: Grady, April
Description: The federal medical assistance percentage (FMAP) is the rate at which states are reimbursed for most Medicaid service expenditures. The FY2006 budget reconciliation bills passed by the House (H.R. 4241) and Senate (S. 1932) include provisions that would affect state FMAPs for Medicaid in a number of ways. This report describes these provisions and estimates their impact on FY2006 FMAPs.
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