Reconciling SCHIP bills more than child's play

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Lawmakers return from their summer recess this month with a hefty homework assignment: reconciling two very different versions of the State Children's Health Insurance Program bill.

Depending on the compromise, skilled nursing facilities potentially could face reductions in Medicare payments for the coming fiscal year. A scaled-back 75% Rule, which currently helps increase the number of residents who come to nursing homes for rehabilitation, also might be a part of the final legislation.
Still another hurdle might be overriding a veto from President Bush, who consistently has vowed to veto the House and Senate bills.
Nursing home advocates have expressed frustration with the House bill for its significant cuts to Medicare. The bill would freeze Part A Medicare payments to skilled nursing facilities for fiscal year 2008, a move that would cut $2.8 billion from SNFs over five years, according to the Congressional Budget Office.
Another blow to facilities would be a House measure to anchor the 75% Rule, which is scheduled to reach its full threshold next year, at the 60% level. (Under the rule, inpatient rehabilitation facilities need a certain percentage of patients with one of 13 conditions to receive higher Medicare funding.)
The Senate legislation would not include Medicare cuts. Instead, it largely would fund SCHIP expansion through higher tobacco taxes.
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