Senate, House include similar health provisions in stimulus bills

Both the Senate and House have passed different versions of an economic stimulus bill. In addition to tax cuts and new government spending provisions, both bills include many provisions that affect healthcare providers. A conference committee will meet this week in an attempt to iron out the differences.

According to a fact sheet from the Senate Finance Committee, here are some of the key differences in the two bills, relating to healthcare.

(1) The House bill allows individuals who lose health insurance because of unemployment to enroll in Medicaid. It also would extend by six months the implementation of certain final rules relating to Medicaid; the Senate version does not include these provisions. 

(2) Both bills provide an additional $87 billion in federal matching funds to states for Medicaid, although the two bills differ in how this money will be allocated.

(3) Under the Senate version, states that expand income eligibility levels in Medicaid will not receive an increased federal match for those newly eligible beneficiaries. Instead, state would receive standard matching rate. The Senate bill also extend payments to hospitals with disproportionate number of low-income, Medicaid, and uninsured patients through December 31, 2010. Finally, the Senate bill provides $3 billion in compensation to states for Medicaid coverage that was legal responsibility of Medicare. The House version of the stimulus bill includes none of these provisions.

(4) Both bills encourage the expanded use of health information technology (HIT). The Senate version includes payment incentives beginning in 2011 for Medicare providers to adopt expanded use of HIT, and penalties for those providerd who don't expand their use of HIT, beginning in 2015. Critical access hospitals (CAHs) will be eligible for incentive payments of up to $1.5 million per hospital. The House version includes similar provisions for incentive payments (except that CAHs are not eligible); penalties for not adopting HIT will kick in starting in 2016 under the House bill.