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Cost Estimate
October 4, 2016
H.R. 5122 would prevent the Secretary of Health and Human Services (HHS) from implementing a proposed demonstration to modify payment for prescription drugs covered under Part B of the Medicare program. The Center for Medicare and Medicaid Innovation (CMMI) will manage the demonstration, and, under current law, CMMI has broad authority and funding to test various projects.
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Cost Estimate
July 25, 2016
H.R. 5713 would modify Medicare’s payments to Long-Term Care Hospitals (LTCHs) and would prohibit Medicare from paying for items or services furnished by certain newly enrolled providers in select areas of the country. CBO estimates that enacting the bill would, on net, increase direct spending by $25 million over the 2017-2021 period but would have no net effect over the 2017-2026 period.
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Cost Estimate
July 21, 2016
Under current law, beneficiaries who develop End-Stage Renal Disease (ESRD) while enrolled in a Medicare Advantage (MA) plan may remain in that plan. However, Medicare beneficiaries are prohibited from enrolling in an MA plan after they have developed ESRD, and must stay in the fee-for-service portion of the Medicare program. H.R. 5659 would eliminate that prohibition, beginning in January 2020.
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Cost Estimate
July 20, 2016
H.R. 5613 would require the Secretary of Health and Human Services to continue to apply an exception to the requirement that certain outpatient therapeutic services be provided under the direct supervision of a physician when they are furnished in critical access and small rural hospitals. This exception would apply through calendar year 2016.
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Cost Estimate
July 7, 2016
Estimate of the direct spending and revenue effects for the conference report for S. 524
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Cost Estimate
July 5, 2016
Direct spending and revenue effects for the draft conference agreement for S. 524
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Cost Estimate
June 29, 2016
Revised CBO estimate of H.R. 4981
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Cost Estimate
June 29, 2016
Under current law, physicians must obtain a waiver from the Substance Abuse and Mental Health Services Administration (SAMHSA) to prescribe buprenorphine to patients with opioid dependency. Those waivers permit the physician to treat up to 30 patients initially; after one year, a physician may apply to increase that cap to 100 patients. S. 1455 would increase the caps to 100 in the first year and 500 in subsequent years. The bill also would permit nurse practitioners and physician assistants who meet certain criteria to apply for those waivers.
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Cost Estimate
June 3, 2016
H.R. 5273 would modify Medicare payment rules for certain hospital outpatient departments and some hospital inpatient services, increase the number of beds for long-term care hospitals (LTCHs), extend a demonstration involving rural community hospitals, modify meaningful use standards for some physicians practicing in ambulatory surgical centers, and delay the Center for Medicare and Medicaid Services’ (CMS) authority to terminate certain Medicare Advantage (MA) contracts.
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Cost Estimate
May 31, 2016
H.R. 4981 would permit nurse practitioners and physician assistants who meet certain criteria to apply for waivers administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). Those waivers would allow them to prescribe buprenorphine products to patients with opioid dependency. Additionally, the bill would permit pharmacists to fill only part of a prescription for certain drugs upon the request of the prescribing physician or the patient.
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Cost Estimate
May 27, 2016
H.R. 4599 would permit pharmacists to fill only part of a prescription for drugs that are listed in Schedule II of the Controlled Substances Act upon the request of the prescribing physician or the patient.
CBO estimates that enacting H.R. 4599 would reduce direct spending by about $122 million over the 2017-2026 period. Pay-as-you-go procedures apply because enacting the legislation would affect direct spending. The legislation would not affect revenues or spending subject to appropriation.
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Cost Estimate
February 16, 2016
S. 2368 would appropriate additional funding for the Office of Medicare Hearings and Appeals and the Departmental Appeals Board within the Department of Health and Human Services. The bill also would modify the hearings and appeals process for Medicare beneficiaries and health-care providers who challenge coverage and payment decisions within that program.
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Cost Estimate
November 3, 2015
The Congressional Budget Office has completed a preliminary analysis of the direct spending effects of title V of H.R. 2646, the Helping Families in Mental Health Crisis Act of 2015, as introduced on June 4, 2015. As described below, title V contains language that makes the implementation of certain provisions contingent on a certification by the Chief Actuary of the Centers for Medicare and Medicaid Services (CMS) that the provisions would not increase net costs. At the request of your staff, CBO estimated the cost of those provisions with and without this language.
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Cost Estimate
October 28, 2015
Estimate of the budgetary effects of H.R. 1314.
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Cost Estimate
September 25, 2015
Tables for H.R. 719 with amendment SA 2689 (the Continuing Appropriations Act, 2016)
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Cost Estimate
September 22, 2015
Tables for the Continuing Appropriations Resolution, 2016
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Cost Estimate
July 21, 2015
S. 1253 would modify Medicare coverage and payment rules for negative pressure wound therapy equipment that includes a disposable pump. CBO estimates that enacting S. 1253 would reduce direct spending by about $21 million over the 2016-2025 period. Pay-as-you-go procedures apply because enacting the legislation would affect direct spending. Enacting the legislation would not affect revenues.
S. 1253 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act.
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Cost Estimate
July 17, 2015
S. 607 would extend the Rural Community Hospital (RCH) demonstration program for an additional five years, through the end of calendar year 2021. Under the demonstration program, Medicare pays certain hospitals in rural areas on the basis of the reasonable costs they incur instead of using the payment rates determined by Medicare’s Acute Inpatient Prospective Payment System (IPPS). CBO estimates that enacting S. 607 would increase direct spending by $27 million in fiscal year 2016 but that this additional spending would be offset in future years.
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Cost Estimate
July 16, 2015
S. 313 would allow physical therapists in areas with a shortage of health professionals, medically underserved areas, and rural areas to utilize substitute physical therapists, in what are known as locum tenens arrangements, under the Medicare program.
CBO estimates that enacting the legislation would increase direct spending by $18 million over the 2016-2025 period. Because the legislation would affect direct spending, pay-as-you-go procedures apply. Enacting the bill would not affect revenues.
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Cost Estimate
July 16, 2015
Under current law, a physician or other professional may be subject to payment reductions for services furnished to Medicare beneficiaries if the provider fails to achieve “meaningful use” of electronic health record (EHR) technology. The meaningful use standard requires that at least half of the provider’s patient encounters occur in a setting that uses certified EHR technology. S.
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Cost Estimate
July 15, 2015
S. 861 would aim to reduce improper payments in the Medicare and Medicaid programs. CBO estimates that enacting the bill would increase revenues by $20 million over the 2016-2025 period. Because the legislation would affect revenues, pay-as-you-go procedures apply. Enacting the legislation would not affect direct spending.
S. 861 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act.
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Cost Estimate
July 10, 2015
S. 704 would establish a demonstration program in the Medicare Advantage (MA) program to test the effectiveness of granting MA plans flexibility to use part of their existing payments to provide for certain long-term care services and supports. The legislation would appropriate $3.5 million for the demonstration program and its evaluation.
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Cost Estimate
July 9, 2015
S. 1349 would require hospitals to notify Medicare beneficiaries receiving observation services for more than 24 hours of their status as an outpatient under observation. The written notification would have to explain that, because the beneficiary is receiving outpatient—rather than inpatient—services:
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Cost Estimate
July 9, 2015
S. 1362 would authorize the Secretary of Health and Human Services (HHS) to waive requirements under section 1934 of the Social Security Act when designing and testing models under the Center for Medicare and Medicaid Innovation (CMMI). Section 1934 authorizes the Program of All-Inclusive Care for the Elderly (PACE), and establishes features of the program including payment rates and conditions of participation. Under current law, CMMI lacks authority to waive those features included in section 1934, and has limited flexibility to test changes to administering the PACE program.
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Cost Estimate
July 7, 2015
Estimated Changes in Mandatory Spending and Revenues in Table 1, and Estimated Authorizations of Appropriations in Table 2.
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Cost Estimate
June 23, 2015
H.R. 6 would authorize appropriations for the National Institutes of Health (NIH), the Food and Drug Administration (FDA), and other agencies within the Department of Health and Human Services (HHS) for programs aimed at promoting the discovery and development of drugs and other technologies that prevent, diagnose, and treat disease or to support activities authorized by the legislation. The bill also would make related changes to those agencies’ programs.
In addition, H.R. 6 contains provisions that would:
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Cost Estimate
June 22, 2015
An amendment to the House amendment to the Senate amendment to H.R. 1295
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Cost Estimate
June 22, 2015
S. 984 would modify Medicare coverage and payment rules for speech-generating devices. CBO estimates that enacting S. 984 would increase direct spending by $28 million over the 2016-2025 period. Pay-as-you-go procedures apply because enacting the legislation would affect direct spending.
S. 984 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act.
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Cost Estimate
June 15, 2015
H.R. 2580 would lift a moratorium in current law that prohibits existing long-term care hospitals (LTCHs) from increasing the number of beds in their facilities. The bill would also reduce the total amount of payments made to LTCHs by modifying the current payment system for patients with very high costs.
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Cost Estimate
June 15, 2015
H.R. 2581 would establish a demonstration program in the Medicare Advantage program, modify the open enrollment period for that program, and change payment rates for prescription drugs that are administered through items of durable medical equipment.
CBO estimates that enacting H.R. 2581 would decrease direct spending relative to current law by $225 million over the 2016-2025 period. Pay-as-you-go procedures apply because the bill would affect direct spending. Enacting the bill would not affect revenues.