A Statement From Congressman Ruben Hinojosa on the Passage of the Medicare and Medicaid Extenders Act

Press Release

Congressman Rubén Hinojosa:

"I am pleased with the passage, by both the U.S. House of Representatives and the U.S. Senate. of legislation that will prevent a significant pay cut for our doctors from taking effect on January 1, 2011. I fully support this bill because it also extends critical Medicare and Medicaid policies that expire at the end of this year. This bill makes certain that our seniors on Medicare and military families will be able to see the doctors they know and trust and will not have to make any changes in who they've selected as their physician."

The Medicare and Medicaid Extenders Act will now be sent to President Obama who will sign it into law.

Following is an overview of some of the bill's key provisions.

Extensions of Key Health Care Provisions:

Extension of Current Medicare Physician Payment Rates/Blocking the Scheduled 25% Cut. Medicare physician payment rates are scheduled to be reduced by 25 percent on January 1, 2011. This provision would block that reduction and instead extend current Medicare payment rates through December 31, 2011.

Extension of Transitional Medical Assistance (TMA). Transitional Medical Assistance (TMA) allows low-income families to maintain their Medicaid coverage as they transition into employment and increase their earnings. TMA expires December 31, 2010. This bill extends TMA through December 31, 2011.

Extension of the Qualifying Individual (QI) Program. This program allows Medicaid to pay the Medicare Part B premiums for low-income Medicare beneficiaries with incomes between 120 percent and 135 percent of poverty. The QI program expires December 31, 2010. This bill extends the QI program through December 31, 2011.

Extension of Exceptions Process for Medicare Therapy Caps. Current law sets annual per beneficiary payment limits for all outpatient therapy services provided by non-hospital providers. HHS was required to implement an exceptions process for cases in which the provision of additional therapy services was determined to be medically necessary. The bill extends the therapy caps exception process through December 31, 2011.

Extension of Several Other Health Care Provisions. The bill also extends several other provisions, including the Special Diabetes Programs, the Medicare physician fee schedule mental health add-on payment, and the Medicare outpatient hold harmless provision.

Other Provisions

Clarification of the Enrollment Period for Veterans Who Participate in Medicare Part B and TRICARE. The bill clarifies that disabled veterans making Medicare Part B elections on and after March 23, 2010 are eligible for a 12-month special enrollment period to ensure that they properly enroll in Medicare Part B and retain their TRICARE eligibility.

Inclusion of Orphan Drugs for Children's Hospitals Under the 340B Drug Discount Program. The bill clarifies that eligible children's hospitals retain access to 340B drug discounts on orphan drugs.

Addition of Clarification for Affiliated Hospitals For Distribution of Residency Positions. The bill makes a technical correction to clarify that residency positions that are being shared between teaching hospitals under an "affiliation agreement" would not be redistributed to other hospitals. There are more than 300 hospitals in 36 states with affiliation agreements in place that are currently using these residency slots.

Medicare Payments to Skilled Nursing Facilities. Under current law, implementation of a refined payment system reimbursing skilled nursing facilities under Medicare is delayed until October 1, 2011. The bill repeals the delay and allows the payment system to go into effect on October 1, 2010.

Various Other Provisions. The bill also includes various other miscellaneous provisions, including technical corrections to Medicaid and CHIP.

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