Extenders Bill – with NAPH Priorities – Delayed Again - May 20, 2010

After announcing plans to bring a catch-all bill (H.R. 4213) extending expiring programs and tax policies to a floor vote tomorrow, House leaders backtracked, announcing that there will be no votes tomorrow. While the language of the bill has not been released and may change, a comprehensive summary provides information on key issues for safety net hospitals.

• The bill will include a six-month extension of enhanced federal Medicaid payments to states (FMAP), until June 30, 2011.
• The bill includes and a partial extension of 340B drug discounts to the inpatient setting of some safety net hospitals. The inpatient extension will only be provided to hospitals with a Disproportionate Share Hospital (DSH) adjustment percentage of greater than 20.2 percent. Additionally, only drugs administered to uninsured patients and those whose insurance does not cover the cost of the drug will be discounted.
• The bill provides a Medicare Sustainable Growth Rate “Doc Fix” through 2013. According to the summary, the provision “would provide reasonable updates in physician payment rates for the rest of this year and next year. For 2012 and 2013, rates would continue to increase if spending growth on physician services is within reasonable limits, with an extra allowance for primary and preventive care. Rates could not be reduced in 2012 or 2013, but after that rates would return to their current law levels.”
• The bill does not stop a scheduled cut in state Medicaid DSH allotments beginning in October 2010, when the increased DSH allotment provision from the stimulus law expires.

In the Senate, Majority Leader Harry Reid (D-NV) has announced that after passing a financial overhaul bill, the chamber will move to a war supplemental bill before dealing with the extenders package. While Sen. Reid said he wants to pass the extenders bill before Congress recesses for Memorial Day, it is possible that Congress will instead pass another short-term extender bill – which likely would not include FMAP or 340B – and take up the larger bill after the recess.

NAPH has joined with other national associations in urging Congress to immediately pass the six-month extension of enhanced FMAP. NAPH spearheaded a letter to congressional leaders by six national hospital associations and joined other safety net providers in running an advertisement in today’s Roll Call.