Health Care Reform Vote Expected in House

VHCA (11/6/2009)

The U.S. House of Representatives is scheduled to vote on health care reform legislation as early as Saturday, November 7. As reported last week, the new bill contains $24.9 billion in Medicare cuts to SNFs, transparency and oversight provisions, a temporary Medicaid supplemental program, an extension of the therapy caps exceptions process, and workforce development provisions.  Earlier today, VHCA/VCAL made an appeal to our members to contact their Member of Congress.  Time is running out to make sure that Congress understands the impact on our ability to deliver high-quality long term care services.  Contact your Member of Congress now!

In addition, late Tuesday evening, Democratic leaders released a “Manager’s Amendment” that contains changes to the bill. The Manager’s Amendment contains a number of provisions that have some impact on the delivery of long term care.  Those provisions include:

• A “savings clause” for state medical malpractice laws providing that nothing in the act will modify or impair state medical malpractice law or the ability of states to make/implement these laws. ACHA/NCAL supports this provision, but would encourage the Congress to strengthen medical malpractice limitations at the federal level. 
• A change in the date for SNF classification changes.  Section 1111 of H.R. 3962 shifts some funds out of the case-mix adjusted therapy component of the SNF PPS and into the non-therapy ancillary services portion of the case-mix adjusted nursing component of the SNF PPS rate. In H.R. 3962 the shift takes effect on January 1, 2010, but the Manager’s Amendment changes the effectiveness date to April 1, 2010. 
• Reimbursement for criminal background checks that provides that states may agree to pay long term care facilities/providers for all costs attributable to conducting background checks and screening under the Nationwide Criminal Background Check Program. Federal funding available to the states is limited to the amounts available under the program funding provision of this title ($160,000,000).
• Quality Indicators for Care of People with Alzheimer’s disease requires the Secretary to develop and implement indicators to measure the quality of care for patients with Alzheimer’s and other dementias by physicians, hospitals and other appropriate providers.

Republican leaders in the House released a health care reform alternative this week. Their bill, which focuses on insurance reform, contains no cuts to Medicare or Medicaid and includes some medical malpractice reform. The Republican alternative is expected to be offered as a substitute amendment on the House Floor, but is expected to fail along party lines.  Democratic Leaders in the Senate continue negotiations to secure enough votes to pass its bill while awaiting cost estimates from the Congressional Budget Office.