Medicare Fee-for-Service Modifications and Medicaid Provisions of S. 1, as Passed by the Senate, and H.R. 1, as Passed by the House: Searching Inside

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... H.R. 1 Extend Medicare's Private contracting allows a physician and No provision.... Section 604. Doctors of dental surgery or of private contracting Medicare beneficiary not to submit a... would be able to enter into private podiatrists paid for by Medicare. Under private... contracting, contracts with Medicare beneficiaries. physicians (not... specified by Medicare. If a physician decides to enter a private contract with a Medicare beneficiary

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... the Medicare and You handbook. The health agencies. The Secretary is required to information would be required... to be presented provide Medicare beneficiaries annual in a separate section on advance directives... and information about Medicare benefits, would include specific information about living limitations...-term care. This care. The Secretary would further be required information is provided to Medicare... to note the inclusion of this information in the beneficiaries in the Medicare and You introductory

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... Medicare Fee-for-Service Modifications and Medicaid Provisions of S. 1, as Passed by the Senate... and Medicare Improvement Act of 2003 by a vote of 76-21. Later that same evening, the House passed the Medicare..., establishment of demonstration projects as well as new beneficiary cost-sharing provisions in the Medicare fee...-for-service (FFS) program. Provisions affecting the Medicaid program are included also. The majority of Medicare...-related provisions are also included in Title VI. Comparable Medicare FFS changes are in Title III through Title VII

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... H.R. 1 Cover diabetes On July 1, 1998, Medicare began covering No provision... would be covered under Medicare. Starting January 1, 2004, these services would be paid using... providers Medicare pays for telehealth services that are Section 450H. Other types of providers would... Medicare for telehealth services. In addition, office, a critical access hospital, a rural health...-state practitioner licensure across state boundaries. Prohibit private insurers The Medicare benefit does

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... H.R. 1 Cover marriage Medicare will cover services connected with the Section 448.... Starting January 1, 2004, Medicare No provision. counseling and family treatment of a mental... of the patient's plans for patients. condition. Cover all Part B services Medicare will cover specific Part B... services Section 450C. All Medicare Part B items and No provision. provided by Indian provided by a... organization. be reimbursed. Cover cardiovascular Medicare covers a number

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... Congress on the implications if Medicare's health conditions... are not patients who are not Medicare beneficiaries, Medicare beneficiaries... unless otherwise calculated on a timely basis by the Secretary. Medicare payments would be reduced... to reflect copayments. Qualified Medicare beneficiaries, beneficiaries dually eligible for Medicare... amounts would be prohibited. Suspend OASIS Medicare is required to monitor the quality

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... Cost-Sharing Amounts Establish beneficiary cost- Medicare pays laboratories directly for Section 431... to ambulatory Medicare would pay all clinical laboratories diagnostic services not patients in an outpatient.... The Medicare Part B deductible imposed. would apply to clinical diagnostic...). Increase Part B deductible Under Part B, Medicare generally pays 80% of Section 433. The Medicare Part B... for covered services after would be set at $100 through 2005 and then Medicare Part B deductible would

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... H.R. 1 Establish consumer- No provision. Medicare coverage requires that No provision.... general, Medicare pays the provider that evaluate method.... reduce the cost of care provided to Medicare beneficiaries with chronic conditions including methods... establish the demonstrations located in an urban area, a rural area, and an area that has a Medicare... integrated care improvement for Medicare beneficiaries with multiple or severe chronic conditions across

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... 31, 2004. Establish consumer No provision. Medicare coverage requires that a No provision... to outpatient services general, Medicare pays the provider that delivers.... reduce the cost of care provided to Medicare beneficiaries with chronic conditions including methods... establish the demonstrations located in an urban area, a rural area, and an area that has a Medicare... integrated care improvement for Medicare conditions

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... Medicare Fee-for-Service Modifications and Medicaid Provisions of S. 1, as Passed by the Senate... and Medicare Improvement Act of 2003 by a vote of 76-21. Later that same evening, the House passed the Medicare..., establishment of demonstration projects, as well as new beneficiary cost-sharing provisions in the Medicare fee...-for-service (FFS) program. Provisions affecting the Medicaid program are included as well. The majority of Medicare...-related provisions are also included in Title VI. In H.R. 1, comparable Medicare FFS changes are in Title III through

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... payments for the technical Section 734. Similar provision except Medicare separate payments of directly... payments for the technical certain inpatient pathology services provided to Medicare be made... Physicians that provide services to Medicare Section 450K. For 2004, physicians in Alaska No provision.... based on Department of beneficiaries are paid based on Medicare's would be paid 90% of the VA.... would be increased by the update amount for the Medicare physician fee schedule for 2005. If no VA fee

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... determinations made under Medicare in the previous year. Information on how to get more information about.... The Secretary would be required Section 735. Medicare would be required to cell transplant existing... authorities, Medicare covers the to establish a 5-year demonstration project to pay the routine costs... includes items or services typically provided related items and services for Medicare investigation... of complications) that arises from the provision of an investigational item or service. Medicare does not pay

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... Contents Modifications to Fee-for-Service Medicare .............................. 3 Provisions... .................................... 46 Chronic Care Improvement ................................. 49 Medicare Secondary Payor (MSP...) ............................ 51 Other Medicare A and B Provisions .......................... 51 Medicare Demonstration Projects

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..., because Medicare law requires that time patient of a skilled nursing facility who covered DME... shoes for diabetic circumstances, Medicare will pay for extra... of amounts if shoes and inserts of an appropriate coverage under Medicare Part B... that there is no net increase in Medicare expenditures.

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... of the drug provisions on the access of Medicare would be due 2 years after the implementation provisions... market prices to Medicare payments for drugs that represent the largest portion of Medicare spending... of certain outpatient drugs and Section 450E. In 2004 and 2005, Medicare No provision. injected drugs... Medicare Part B, these items are covered if they biologicals that are prescribed as complete are usually

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... H.R. 1 Pay the physician a Medicare pays for certain outpatient prescription Section 432(b)(8...). Medicare would pay a No provision. pharmacy dispensing drugs and biologicals. For instance, Medicare... immunosuppressive drugs, oral anti- Medicare does not pay a dispensing fee to cancer drugs, and oral anti- nausea... regimen. Medicare would be able to pay a dispensing fee (less the applicable deductible and coinsurance... amounts) to licensed approved pharmacies for other drugs and biologicals. Pay for discarded Medicare

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... H.R. 1 Require MedPAC to The Medicare Payment Advisory Commission No provision... recommendation and review the factors with its recommendations Medicare payment policies. The Comptroller.... would study the solvency and financial circumstances of hospitals and other Medicare providers... investments, capital financing and access to capital of hospitals participating under Medicare. Members.... Change Emergency Medical Medicare participating hospitals that operate an No provision

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... CRS-3 Modifications to Fee-for-Service Medicare Provisions Relating to Part A Hospital Services... H.R. 1 Inpatient Prospective Payment System (IPPS) Hospitals Increase standardized amounts Medicare... pays for inpatient services in acute Section 401. Medicare would pay hospitals Section 402. Similar... and small urban areas in the fifty to discharges in the fifty states. Two hospitals in Medicare... compute one standardized amount for rates Medicare discharges from April 1, 2003, to hospitals

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... H.R. 1 Permit nurse Medicare covers hospice services to care for the Section 407... of hospice No provision. Section 512. As of January 1, 2004, Medicare... consultation services in services, in lieu of certain other Medicare... the hospice benefit. Medicare only after the beneficiary has elected the hospice benefit. Establish rural... hospice Medicare's hospice services are provided No provision. Section 418

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... of the Senate that Medicare reform should be Medicare reform... disease is expensive, of national lifestyle the Medicare..., which health coverage for would add a new Medicare... that was supplemental to benefits provided under a Medicare Prescription Drug Plan or a MedicareAdvantage plan. Expand..., cooperative agreements, HHS in the Medicare and Medicaid programs on the and contracts

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