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COPYRIGHT 2003 Thomson Financial Inc.
The congressional conference committee that will begin this week to seek compromise between House and Senate versions of a Medicare prescription-drug bill will also have numerous other smaller matters on its plate.
The following are some secondary provisions that are included in both chambers' bills, making them among the most likely smaller provisions to be enacted:
* Equalizing base hospital payment rates. Both bills would permanently raise standardized base payments for hospitals in rural and small-urban areas to equal those for facilities in large-urban areas.
* Adjusting the labor-related share of hospital payments. To further close the payment gap among hospitals, both chambers would lower the so-called labor-related share--the portion of base hospital payments to which an area wage index is applied. The labor-related share would drop from 71 percent to 62 percent under both bills.
Some hospitals would see their payments drop if the proposed new formula were strictly followed, a fact that's led hospital groups in the past to be leery of pushing hard for this change. In both current bills, hospitals whose payments would drop under the new formula would be paid as if the old formula were still in effect. To accommodate this so-called hold-harmless feature, under both bills the labor-share provision would not be required to be budget neutral but would be permitted to increase federal spending.
* New provisions for critical-access hospitals. Both bills aim at making life easier for critical-access hospitals--rural hospitals that generally have 15 or fewer acute-care beds with a total of 25 beds including so-called swing beds; are 35 miles or more from another hospital or are designated as "critical" by the state;...
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