Highlights of House-passed legislation the Senate debated Tuesday changing how Medicare reimburses doctors. The bill would spend $214 billion over 10 years:
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— Medicare payments to doctors: $175 billion. Blocks 21 percent reduction that technically took effect April 1. Provides 0.5 percent annual increases through 2019, creates new payment system with incentives for doctors to bill for overall care, not per treatment.
— Children's Health Insurance Program: $5.6 billion so program serving low-income children can operate in 2016 and 2017.
— Extension of expiring Medicare programs: $6 billion. Two-year renewals for extra payments for rural hospitals and ambulances, private Medicare Advantage plans for people with disabilities, exemptions to annual patient limits on physical and occupational therapy.
— Miscellaneous health programs: $27 billion. Makes permanent programs subsidizing Medicare medical premiums for low-income people, keeping people on Medicaid as their incomes grow. Includes extra $3.6 billion annually for two years for community health centers. Extends financing for abstinence education, training low-income people for health care jobs, home-care visits for families with young children.
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HOW IT'S FINANCED
— $141 billion added to federal deficits.
— $35 billion from higher-income Medicare recipients. In 2018, Medicare's medical and prescription drug monthly premiums would rise for people earning from $133,500 to $214,000, roughly 2 percent of beneficiaries, according to nonpartisan Kaiser Family Foundation. In 2020, income thresholds that trigger higher premiums would rise less than planned, so more people would pay them. Also starting in 2020, people could not buy new Medigap policies covering Medicare's medical deductible, currently $147 yearly.
— $37 billion from reducing Medicare payments to hospitals, nursing homes, home health services. Treasury Department can impose levy of up to 100 percent on Medicare providers owing delinquent taxes.
— Helps Medicare cost plans, offered by private companies in some states, become private Medicare Advantage plans, which are generally more profitable. Dominant companies include Blue Cross and Blue Shield and Medica Health Plans, according to Kaiser, and most of the 471,000 people covered last year lived in Minnesota.
— Hospitals won 6-month extension of ban on auditors examining whether short in-patient stays are medically necessary.
Figures are rounded, from Congressional Budget Office and Congressional Research Service.