Health Care Bill - Part Ten

Back to reading the health care bill...

Coming from where I left off in the previous section nine, there is information about rebates for drugs. I think this is talking about the federal government paying money to the states for types of drugs but, it is somewhat unclear.

On pg. 510, Subtitle G—Medicaid Disproportionate Share Hospital (DSH) Payments

This section is discussing payments that will be made for the uninsured. It says it will be fifty percent but, then goes on to say that this will be lowered if the Secretary determines to do so based on census and, the amount of people in the state that are uninsured.

Subtitle H—Improved Coordination for Dual Eligible Beneficiaries pg. 515

This is discussing those individuals enrolled in Part A or B, and who are also eligible under the State plan. They discuss something about a 5 year period that, I understand as them saying the person will be covered with both. Again, it lists the Secretary as the arbiter as to whether they will extend this for the State an additional 5 years.

Pg. 517 SEC. 2602. PROVIDING FEDERAL COVERAGE AND PAYMENT COORDINATION FOR DUAL ELIGIBLE BENEFICIARIES

No later than Mar 1, 2010, the Secretary shall establish a Federal Coordinated Health Care Office. They list a bunch of reasons for doing this. Apparently, they want someone who will be set up within the Medicare and Medicade system, who is going to establish a way to coordinate communication with these programs and the Federal government. This goes hand in hand with the rest of what has been stated about getting more people on the General government program. I am thinking that eventually, Medicade and Medicare will be no more.  I haven't read that specifically but, it seems as though this would be the logical progression.

Subtitle I—Improving the Quality of Medicaid for Patients and Providers pg. 522

This is requiring that the Secretary, define and report what core health quality measures. This must be recommended by the Secretary before Jan 1, 2010.

Pg. 526 SEC. 2702. PAYMENT ADJUSTMENT FOR HEALTH CARE-ACQUIRED CONDITIONS.

Health care-acquired condition’’ means a medical condition for which an individual was diagnosed that could be identified by a secondary diagnostic code described in section 1886 of the Social Security Act.

The Secretary is going to identify current state practices that prohibit payments for health care acquired conditions. The Secretary then, is asked to determine what is appropriate.

Pg. 528 SEC. 2703. STATE OPTION TO PROVIDE HEALTH HOME FOR ENROLLEES WITH CHRONIC CONDITIONS

Once again, the Secretary is going to determine everything. The maximum given to states under this section is $25 million.

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