AAHSA's Washington Update from 12/24/2009

Health care reform legislation passed the Senate on December 24. The vote was 60-39, which was not a surprise. 

Before the bill passed, the Senate adopted Sen. Harry Reid’s manager’s amendment, a comprehensive package of changes to the original bill.  

As Larry Minnix informed you last week, the CLASS provisions were retained in the manager’s amendment, so CLASS is now in both the House and Senate bills. This puts us in a very strong position as members of the House and Senate hammer out the final legislative language of health care reform. It would be very unusual for provisions contained in legislation as passed by both houses to be dropped from the final product. When the conference report eventually comes to a final vote in the two houses, it will be up-or-down, for-or-against the entire package, with no opportunity to remove specific provisions.

Other issues remain to be resolved during the conference process that will begin next week and which may last through January. In general, the Senate’s Medicare provisions are more favorable than those in the House bill, since the Senate would allow the full payment update for nursing homes in 2010 and 2011 with reduced updates in subsequent years.

The Senate provisions on civil monetary penalties assessed for nursing home survey deficiencies are also far preferable to those in the House bill. The Senate would not increase CMP amounts as the House bill would, and the Senate’s provisions for CMPs to be held in escrow pending a nursing home’s appeal would apply to fewer situations and a shorter period of time than the House bill would.

But there are provisions in the House bill that we do like, especially the six-month extension of the increase in the federal Medicaid match, now set to expire December 31, 2010, and the two-year, $6 billion funding for nursing homes with large proportions of dually-eligible residents.

So our advocacy will continue during the conference period as we urge House-Senate conferees to include provisions that will give our members the best possible resources for providing high-quality services and supports to frail elders.

We also have unfinished business with Medicare Part B fees tied to the physician payment schedule, which will be revisited in February, and to get the therapy caps exceptions process extended.

 But for now we just want to thank all of you for the hard work you’ve done all year and especially for all of your efforts to gain passage of the CLASS plan. It would not have happened without you.