The Senate voted 86-12 to attach a series of hospital payment changes to a tax-cut package being debated. The changes would become law only if the larger legislation passes. They include permanent equalization of the base payment rate for rural and urban hospitals; more equitable distribution of disproportionate-share payments among rural and urban hospitals; a more flexible bed limit in the critical-access hospital program; a 5% add-on payment for rural home health agencies; and targeted assistance for low-volume hospitals. To offset the cost of the changes, the federal government would freeze payment increases for 10 years for durable medical equipment and prosthetics and orthotics, establish deductibles for coinsurance and clinical laboratory services, and limit reimbursement for Medicare-covered drugs. The Senate also approved an amendment to the tax package that would provide $20 billion in fiscal relief to states, with $10 billion earmarked for Medicaid. At deadline, Sen. Debbie Stabenow (D-Mich.) was preparing to introduce a prescription drug amendment to the tax bill; further details were not available. -- by Jeff Tieman
Hospital payment changes attached to tax-cut bill
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