Vote expected soon on Senate healthcare reform bill

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A vote on Senate Finance Committee healthcare reform legislation could occur by the end of this week. The 262-page bill contains a number of amendments that could affect long-term care supports and services.

A pilot program to test payment bundling would be set up under the proposal. Beginning in 2013, the Department of Health and Human Services would implement a voluntary trial program. Bundling is a concept to help cut down on the number of unnecessary hospitalizations. It implies that one healthcare provider, such as a hospital, would disburse post-acute payments to various post-acute providers, including skilled nursing facilities, inpatient rehabilitation facilities, long-term care hospitals and home health agencies. The period covered would be 30 days after a hospital stay.

The Finance Committee also proposed in its bill the creation of the Federal Coordinated Health Care Office (CHCO). The CHCO would serve as a liaison between Medicare and Medicaid officials to provide services for dual eligibles, or those who receive Medicaid and Medicare. CHCO would also be required to submit to Congress an annual report containing recommendations for legislation that would improve care coordination and benefits for dual eligibles. The commitee previously considered establishing the Office of Coordination for Dual-Eligible Beneficiaries (OCDEB), but that has been stricken from the finalized language of the bill.

The bill would also establish the Community First Choice Option, which would create a state plan option to provide community-based supports and services to Medicaid-eligible individuals with disabilities who require an institutional level of care. States that choose the Community First Choice Option would be eligible for more federal matching funds for reimbursable expenses in the program. The bill would also give states that restructure their long-term care systems to include more home- and community-based services an increased federal medical assistance percentage (FMAP).