Comprehensive health care reform legislation passed a significant milestone last week as Senate and House committees approved different legislative packages. At the same time, comments from the head of the Congressional Budget Office (CBO) put a damper on the potential further progress of the legislation.

Late on Wednesday, Feb. 11, the House and Senate reached agreement on final language for the American Recovery and Reinvestment Act. President Obama is expected to sign the bill into law as soon as it reaches his desk. An unofficial  summary of the conference agreement includes the following health-related provisions --

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.

As officials in Wisconsin received a letter from the Office of Inspector General indicating that the state's false claims act meets the requirements of the Deficit Reduction Act of 2005, New Jersey officials learned that their false claims statute will have to be amended for the state to become eligible for an increase in its share of Medicaid false claim recoveries. OIG determined that New Jersey's false claims statute is not as effective in rewarding and facilitating qui tam actions as the federal False Claims Act.

The Senate Finance Committee on January 15 approved legislation to renew and expand the State Children’s Health Insurance Program (SCHIP) by a vote of 12 to 7. The $31.5 billion measure funds investment in the SCHIP program with a 61 cent increase in Federal tax on cigarettes, with proportional increases for other tobacco products, raising approximately $65 million over 10 years. The House passed a similar measure (HR 2) on January 14 by a vote of 289-13. The full Senate is expected to take-up its version during the week beginning January 19.

The House Appropriations Committee on Jan. 15 issued the outline for an $825 billion stimulus package which includes several provisions relating to Medicare and Medicaid.

The proposal (for which actual legislative text is still being written) would provide $8.6 bilion to provide 100 percent federal funding to states through 2010 for optional state Medicaid coverage of individuals and their dependents who are involunitarily unemployed and whose income is no higher than 200 percent of the federal poverty level.

The House of Representatives on Jan. 14 passed, by a 289 to 139 vote, HR 2, the State Children's Health Insurance Program (SCHIP) Reauthorization bill.  The legislation is intended to expand the number of children covered by health insurance under SCHIP or Medicaid from 7 million to 11 million.

The state of Alabama on Nov. 3, 2008, sued CMS for what it called “illegal rulemaking” concerning a letter the agency sent to all states on October 28 setting guidelines for states to reimburse the federal government for amounts states gained from suits filed under a state Medicaid False Claims Act. In the suit, Alabama claims the requirements outlined in the letter (1) constitute illegal rulemaking in violation of the Administrative Procedure Act; (2) are in excess of CMS’ statutory authority; and (3) would violate state sovereignty.

Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) (PubLNo 110-275)

The Social Security Act sections related to the Medicare and Medicaid programs, as published in the CCH Medicare and Medicaid Guide, have been updated to reflect the “Medicare Improvements for Patients and Providers Act of 2008” (MIPPA) (PubLNo 110-275). The law section now includes revisions of existing law, the addition of new sections enacted by MIPPA, and updated amendment notes and histories.

Reimbursement Integrated Library

Dennis Barry’s Reimbursement Advisor

Each month, Dennis Barry’s Reimbursement Advisor includes two or three articles the offer practicalanalysis on specific aspects of healthcare provider reimbursement. Thenewsletter is particularly helpful in explaining some of the more complex areasof Medicare reimbursement and regulation. A good example of this is the leadstory in the July 2008 issue on Medicare bad debt. The article explains how a