The Senate put forward its version of health insurance reform on Wednesday, (here is the complete text of the HR 3590** the Patient Protection and Affordable Care Act).
There does not appear to be a provision to extend immunosuppressant
drug coverage beyond the 36 months already covered. It is disappointing
that the Senate did not include language echoing the House health
insurance reform bill, HR 3962. I don't know how likely it is for the
Senate to introduce an amendment that would put immunosuppressants in
the bill but that would be best. Ideally the immunosupprssant drug
language could be added without mandating that the dialysis bundle include binders and calcimimetics. (Even without language in the Senate bill most people expect the House's immunosuppressant drug coverage language to make it into the final bill.)
There appear to be two sections that directly relate to the provision of dialysis. On page 903 and 904 as part of SEC. 3202. BENEFIT PROTECTION AND SIMPLIFICATION the dialysis language, I think, relates to Medicare Advantage plans. The
first time I tried to make sense of it I thought it might mandate patient copays to stay the same under the new bundle - as it stands
under the proposed rule patient copays will increase with the inclusion in the bundle
of labs, and binders and calcimimetics which are now paid
through Part D plans. On my subsequent reads I decided it relates to Medicare Advantage beneficiaries but I'm not sure. (I welcome clarifying comments if someone has read through and made sense of the language.)
On page 988 as part of SEC. 3401. REVISION OF CERTAIN MARKET BASKET UPDATES AND INCORPORATION OF PRODUCTIVITY IMPROVEMENTS INTO MARKET BASKET UPDATES THAT DO NOT ALREADY INCORPORATE SUCH IMPROVEMENTS, there appears to be language that reverses the language in MIPPA that mandated a 1% decrease in the market basket adjustment every year. The MIPPA requirement to forever reduce the yearly inflation adjustment by 1% was not a fair; I think, based on my first read this new language puts the decision in the hands of CMS.
Dialysis providers will be very happy to see the automatic 1% decrease go away.
** It is confusing that the Senate health insurance reform
legislation HR 3590 started life as a bill in the House of
Representatives that dealt with military personnel who are first time home buyers. Article 1, Section 7 of the US Constitution requires all legislation having to do with revenue to originate in the House of Representatives. As a work around for legislation that includes revenue provisions, the Senate takes an unrelated House bill, strikes all language except the "enacting clause" and then amends the bill with new language, including a new name - in this case the Patient Protection and Affordable Care Act.
Where can I find a copy of the Senate Health care bill? I could not find it on the internet after a very diligent search. Why is this bill hiden from the public? What kind of democracy are we descinding to in the US. Are the Senate Democrat leaders afraid to let us know what is in the bill?
Posted by: Albert Cinelli | November 21, 2009 at 01:55 PM
Did you try clicking the link? http://www.scribd.com/doc/22735617/Senate-Health-Care-Bill
Posted by: Bill Peckham | November 21, 2009 at 02:47 PM
What's going to happen with Hemodiafiltration Therapy? Will it ever make it to the U.S.?
Can the Health Bill be revised to include that?
Posted by: Lawrence Lev | December 05, 2009 at 05:16 AM