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House Also Considers COBRA Extension, Healthcare Fraud

Janice Simmons, for HealthLeaders Media, May 24, 2010

Funding for claims reprocessing. Extensions of Medicare payment policies for 2010 were enacted into law on March 23, 2010, requiring CMS to reprocess Medicare claims back to Jan. 1, 2010. The bill would provide funding for CMS to reprocess these claims. This provision costs $175 million over 10 years.

Waiver of coinsurance for preventive services. The bill would clarify that waivers of cost sharing and deductibles for Medicare preventive services apply when those services are furnished at federally qualified health centers and rural health clinics. This provision has no cost.

Addition of inpatient drug discount program. Under current law, drug manufacturers are required to provide certain hospitals and other entities treating low income and uninsured patients—including certain public hospitals, critical access hospitals, children's hospitals, and cancer hospitals—with discounts so the cost of outpatient drugs for these entities does not exceed the Medicaid price for the same drug. The bill would extend these discounts for certain 340B eligible federal entities to inpatient drugs for use by patients who are uninsured or who do not have insurance that provides prescription drug coverage. This provision is estimated to cost $35 million over 10 years.

Orphan drugs. Inclusion of orphan drugs in definition of covered outpatient drugs with respect to children's hospitals under the 340B drug discount program would continue. This provision would clarify that eligible children's hospitals retain access to federal 340B drug discounts on orphan drugs. This provision has no cost.


Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.

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