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Tax Relief and Health Care Act of 2006

Posted Sep 07 2008 8:40pm
The Tax Relief and Health Care Act of 2006 was signed into law on December 21, 2006.

The White House press release emphasizes the health care impact as follows:

The Act Will Help Make Health Care Affordable And Accessible For More Americans. This Act will bring Health Savings Accounts (HSAs) within the reach of more Americans. HSAs allow people to save money for health care tax-free, and to take these accounts with them if they move from job to job. This Act will raise contribution limits and make the accounts more flexible, let people fund their HSAs with one-time transfers from their Individual Retirement Accounts, allow people to contribute up to the annual limit of $2,850 regardless of the deductible for their insurance plan, and give them the option to fully fund their HSAs regardless of what time of year they sign on to a plan.

There, is, of course, much more than that. (including a section entitled "Designation of wines by semi-generic names.")
The section addressing Medicare and other provisions is called the Medicare Improvements and Extension Act of 2006. It includes:
  • One year increase in the Medicare physician fee schedul conversion factor
  • Ammendments to the Social Security Act (42 USC 139w4) to have the Secretary of HHS to implement a system for the reporting by eligible professionals of data on quality measures. These measures are the measured identified as 2007 physician quality measures under the Physician Voluntery Reporting Program as published on the CMS web site.
  • For 2008, the measures are to be endorsed by a consensus organization such as NQF or AQA. " Such measures shall include structural measures, such as the use of electronic health records and electronic prescribing technology."
  • Registries may be used. The legislation states "the Secretary shall address a mechanism whereby an eligible professional may provide data on quality measures through an appropriate medical registry (such as the Society of Thoracic Surgeons National Database), as identified by the Secretary."
  • There are limitations to administratvie and judicial review under sections 1869, section 1878 and other relvant codes, of the development and implementation of the reporting system,including identification of quality measures, registries, or identifiers.
  • Provision of the appropriate quality measures may qualify practitioners and facilities for a bonus from the Federal Supplementary Medical Insurance Trust fund an amount equal to 1.5% of the estimate of allowed charges for services provided during a reporting period.
  • There are definitions of the amount of services. For example if there are no more than three provided that are applicable and each has been reported by 80% of cases, one is eligible. If 4 or more, the reimbursement is allowed if one reports 80% of at least 3 measures
  • There are limitations to payment. For example, not more than 300% of the average per measure payment.
  • Recommendations for validation are included

As part of this legislation, Section 1848 of the Social Security act is ammended further by creating a new subsection entitled "physician assistance and quality initiative fund."

  • This fund will have available funds of $1.35 billion
  • the fund will be used to pay for the quality payments
  • the legislation describes what will happen if there isn't enough money prior to appropriations

What does this mean?

  • Quality metrics are part of the plan
  • They will be based on consensus groups
  • Use of EMR, e-Rx and other structural measures will be part of the reimbursement

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