Extenders Package Addresses FMAP, RUG-IV, & Physician Fee Schedule

VHCA (5/21/2010)

According to news this morning from the American Health Care Association (AHCA), the House and Senate reached agreement yesterday on the “extenders package” known as the American Jobs and Closing Tax Loopholes Act (H.R. 4213). The House will take up the bill early next week with the Senate to follow later in the week.  H.R. 4213 addresses three key issues for long term and post acute care: elimination of the RUG-IV delay, FMAP, and the physician fee schedule fix.

Of great importance to skilled nursing facilities, the bill calls for the elimination of the implementation delay of RUG-IV to October 1, 2011, which was contained in the Patient Protection and Affordable Care Act (PPACA), so that RUG-IV and MDS 3.0 will be implemented together on October 1, 2010.

On FMAP, H.R. 4213 will extend the temporary Medicaid increase provided by the American Recovery and Reinvestment Act of 2009 for an additional six months December 31, 2010 through June 30, 2011.  This six-month extension impacts Virginia’s Medicaid funding and once passed, will eliminate provider payment cuts, including a scheduled 3% cut to nursing facility rates effective July 1, 2010.

On the physician fee schedule fix, a three-year patch is included. The legislation will provide a 1.3% update effective June 1, 2010 and an additional 1.0% update on January 1, 2011.