Takeaway: Medical Device and Insurance Taxes get another reprieve; CHIP funded for six years; but what about Medicare extenders?

Tonight, the House and Senate approved a Continuing Resolution to fund the government through February 8 thus ending a three day standoff that closed the federal government for a few hours. While the funding is temporary the health care portions of the bill are more long lasting. Specifically:

  • The Children’s Health Insurance Program is funded for six years however the enhanced federal matching rate is reduced from 23 percent to 11.5 percent in FY 2020.

  • The Medical Device Tax gets another hiatus – through 2019

  • The Health Insurance Tax implementation is also delayed through 2019

These health related provisions are a good news for device manufacturers, some of whom are facing a bit of a headwind over tax reform. The delay in the Health Insurance Tax is also welcome news to that industry.

However, it is important to remember that Members, particularly those of the budget hawk ilk, were comfortable voting to delay these health industry taxes because the CBO had indicated earlier in the month that extending CHIP would decrease the deficit by $6 billion.

That trade-off leaves us wondering how Medicare extenders will be offset with CHIP  longer an option. Offsets previously identified by House Ways and Means remain viable:

  • Inclusion of telehealth services as a core benefit of Medicare Advantage

  • Permanent authorization of Special Needs Plans by Medicare Advantage

  • Cost reporting and auditing of ground ambulance services

  • Haircut for NEMT for ESRD patients increased from 10% to 32%

  • Identification and change to over-valued billing codes = 0.5% of Medicare physicians pay

  • Codification of change in SNF payment system

  • Codification of change in HHA payment system

Of course, Congress could always waive that whole budget deficit thing rendering the need for offsets moot.

February 8 will be here before you know it and in the meantime we will keep you informed.

Call with questions.

Emily Evans
Managing Director
Health Policy


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