Medicare: Changes Made by the Reconciliation Act of 2010 to Senate-Passed H.R. 3590

Patricia A. Davis, Coordinator
Specialist in Health Care Financing

Paulette C. Morgan
Specialist in Health Care Financing

Holly Stockdale
Analyst in Health Care Financing

Sibyl Tilson
Specialist in Health Care Financing

Jim Hahn
Analyst in Health Care Financing

On December 24, 2009, the Senate passed health reform legislation that would, among other changes, make statutory changes to the Medicare program. H.R. 3590, the Patient Protection and Affordable Care Act, is under consideration by the U.S. House of Representatives. 

On March 18, 2010, the House Rules Committee issued an amendment in the nature of a substitute to H.R. 4872, the Health Care Education Affordability Reconciliation Act of 2010 (referred to hereafter as the Reconciliation bill). If passed, the Reconciliation bill would amend H.R. 3590. 

The Reconciliation bill includes two titles. The first title contains provisions related to health care and revenues, including modifications to H.R. 3590's Medicare provisions. The second title includes amendments to the Higher Education Act of 1965, which authorizes most of the federal programs involving postsecondary education. 

Medicare changes that would be made by the Reconciliation bill, as issued March 18, 2010, to Senate-passed H.R. 3590 are summarized in this report. Among other changes, the Reconciliation bill would: 

• phase out the coverage gap under the Medicare prescription drug benefit and close it by 2020; 

• change the methodology used to determine Medicare Advantage payment, and create an incentive system to reward high quality plans with higher payments; 

• move up reductions in payments to disproportionate share hospitals to 2014, and reduce the cuts; 

• revise hospital market basket adjustments; 

• change the qualifying date whereby an existing physician-owned hospital would be exempt from the self-referral prohibition; 

• change the assumptions used to calculate Medicare reimbursement for advanced imaging services; and 

• increase funding for the Health Care Fraud Abuse Control program and provide for enhanced oversight of DME suppliers.


Date of Report: March 19, 2010
Number of Pages: 11
Order Number: R41124
Price: $19.95

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