Medicare: Changes Made by the Reconciliation Act of 2010 to the Patient Protection and Affordable Care Act (P.L. 111-148)

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 March 23, 2010, President Obama signed into law a comprehensive health care reform bill, the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), which would, among other changes, make statutory changes to the Medicare program. The U.S. House of Representatives also passed an amendment in the nature of a substitute to H.R. 4872, the Health Care and Education Affordability Reconciliation Act of 2010, on March 21, 2010 (referred to hereafter as the Reconciliation bill), which would amend the PPACA. 

The Reconciliation bill includes two titles. The first title contains provisions related to health care and revenues, including modifications to PPACA'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 passed by the House on March 21, 2010, to the PPACA 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 payments, 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 the adjustments to annual updates for certain providers; 

• 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 25, 2010
Number of Pages: 13
Order Number: R41124
Price: $29.95

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