The ‘Doc Fix’ is in the HIRE Act
Extension of Expiring Health Care Provisions.
The draft HIRE Act also extends health provisions, a number of which expired at the end of 2009. These provisions include a seven-month extension of the sustainable growth rate update formula. Without this fix, physicians participating in Medicare face a 21 percent reduction in payments. The bill also extends the exceptions process for Medicare therapy caps and extends payment provisions for mental health providers, ambulance services, physicians in areas where the work geographic practice cost index (GPCI) is below 1.0, certain physician pathology services, the rural hospital flexibility (Flex) program, improved payments for outpatient services in hospitals in rural areas, direct billing for Indian health service providers, Medicare hospital wage index reclassifications under the section 508 program, provisions concerning long-term acute care hospital services, and certain Medicare Advantage plans, including special needs plans, cost plans and senior housing programs. The draft bill would also provide an accreditation exemption for certain pharmacies that furnish durable medical equipment and would clarify eligibility for physician health information technology incentive payments. And finally, the draft bill would keep the 2009 federal poverty guidelines to protect people in means-tested programs from losing benefits and includes a provision to disregard refundable tax credits and refunds as income for twelve months from receipt. The total cost of the health extenders provisions is about $10 billion over ten years.
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