A bill to provide for prospective payment rates under Medicare for inpatient hospital services, and for other purposes.
Medicare Prospective Payment Rates Act - Amends title XVIII (Medicare) of the Social Security Act to provide that payments for inpatient hospital services shall be made on a prospective basis, except for psychiatric, long term, or children's hospitals. Bases payments to hospitals not paid on the prospective basis on target amounts.
Sets forth a method for determining prospective Medicare payments which shall be based upon the national standard rate per discharge for the diagnosis related group to which that discharge belongs.
Permits a Health Maintenance Organization (HMO) or a Competitive Medical Plan (CMP) receiving payments on a risk basis to choose to be reimbursed either on a reasonable cost basis or on a prospective basis for inpatient hospital services furnished to HMO or CMP enrollees. Provides that any reimbursement will be deducted from Medicare payments to an HMO or CMP.
States that this Act shall not affect the authority of the Secretary of Health and Human Services to develop, carry out, or continue experiments and demonstration projects.
Sets forth conforming amendments and effective dates.
Indefinitely postponed by Senate by Unanimous Consent.
See H.R.1900.
Introduced in Senate
Read twice and referred to the Committee on Finance.
Committee on Finance requested executive comment from OMB, Treasury Department, Health and Human Services Department.
Committee on Finance. Provisions of measure incorporated into measure S. 1 ordered to be reported.
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