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 Page: 14 of 76
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CRS-11
Provisions Current Law S.1 H.R. 1
Authorize periodic interim Eligible hospitals, skilled nursing facilities, and Section 405(d). Starting with payments Section 405(d). Same provision but would
payments for eligible CAHs hospices which meet certain requirements made beginning January 1, 2005, an eligible be effective January 1, 2004. Also, the
receive Medicare periodic interim payments CAH would be able to receive payments Secretary would be required to develop
(PIP) every 2 weeks; these payments are based made on a PIP basis for inpatient services. alternative methods based on the expenditures
on estimated annual costs without regard to the of the hospital for these PIP payments.
submission of individual claims. At the end of
the year, a settlement is made to account for any
difference between the estimated PIP payment
and the actual amount owed. A CAH is not
eligible for PIP payments.
Exclude beds in distinct-part Beds in distinct-part skilled nursing facility units Section 405(g). The Secretary would not be No provision.
units from CAH bed count do not count toward the CAH bed limit. Beds in able to count any beds in a distinct-part
distinct-part psychiatric or rehabilitation units psychiatric or rehabilitation unit operated by
operated by an entity seeking to become a CAH the entity seeking to become a CAH for
count toward the bed limit. designations beginning October 1, 2003. The
total number of beds in these distinct-part
units would not be able to exceed 25. A CAH
would be able to establish a such a distinct-
part unit.
Establish CAH improvement No provision. Section 415. The Secretary would be No provision.
demonstration program required to establish a budget neutral 5-year
CAH demonstration program in four areas
including Kansas and Nebraska to test various
methods to improve the CAH program.
Services would be paid either on the basis of
its reasonable costs (without regard to
customary charges) or using the relevant PPS
for those services. In this instance,
reasonable cost reimbursement of capital
would include a return on equity payment of
150% of the average rate of interest paid by
the Hospital Insurance (HI) Trust Fund.
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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, report, July 17, 2003; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc821759/m1/14/?q=medicare: accessed April 23, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.