Practice Economics

House curbs Medicare premium increase under budget deal


 

References

Lawmakers are seeking to limit an increase in Medicare Part B premiums as part of the budget deal negotiated between outgoing House Speaker John Boehner (R-Ohio) and the White House, and approved by the House on Oct. 28.

The House approved the Bipartisan Budget Act by a vote of 266-167. The Senate is expected to act on the deal shortly.

Alicia Ault/Frontline Medical News

The deal means that some Medicare beneficiaries will avoid seeing their Part B premiums jump from about $105 to $160 per month. Instead, those beneficiaries who are not “held harmless” under Medicare rules – about 30% of Medicare beneficiaries – would see their premiums rise to $120 in 2016. The bulk of Medicare beneficiaries will have stable premiums at about $105 next year.

To pay for the rollback of part of the increase, the budget agreement also calls for those beneficiaries not held harmless under the law to pay an extra $3 per month starting in 2016.

But an analysis of this provision by the National Center for Policy Analysis noted that such adjustments could happen again, as they are tied to the a cost of living adjustment. This is “just another case of Congress kicking the can down the road,” NCPA officials wrote in an Oct. 28 blog post.

The budget deal included only a few other health care–related provisions. The bill would broaden the application of inflation-triggered rebates – the rebates paid by manufacturers when drug price increases outpace inflation – to generic drugs as well as brand name drugs.

Another provision codifies the definition of provider-based off-campus hospital outpatient departments that are not on the main campus and are more than 250 yards away from the main hospital campus. Providers at these off-campus locations would be reimbursed under the ambulatory surgical center prospective payment system or the Medicare physician fee schedule rather than the hospital outpatient prospective payment system.

Finally, the budget bill eliminates a requirement from the Affordable Care Act that mandates that employers with more than 200 workers automatically enroll new full-time employees into a qualifying health plan if it is offered, and automatically reenroll existing employees.

gtwachtman@frontlinemedcom.com

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