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- W1998593302 abstract "After nearly nine months of con-gressional committee hearings, contentious town hall meetings, and a bipartisan summit hosted by the White House, President Obama signed the primary healthcare reform legisla-tion into law on March 23, 2010 and the change package into law on March 30, giving the President a huge victory on his top domestic priority. When Congress returned to Washington, D.C. in January to begin the Second Session of the 111th Congress, many thought the House and Senate were close to a compromise on the content of health-care reform legislation. However, negoti-ations on a final bill were stalled when, on January 19, Republican Scott Brown was elected to the Massachusetts Senate seat vacated by the death of Senator Edward Kennedy. Brown's election effectively took away the Senate Democratic leader-ship's 60th vote in support of healthcare reform legislation. Without the fi libuster-proof 60 votes in the Senate, Democrats would not have been able to overcome the procedural hurdles to passing a fi nal House-Senate compromise bill without Republican votes. As a result, pressure mounted on Speaker Nancy Pelosi (D-Calif.) for the House to take up and pass the Senate-approved healthcare reform bill, the Patient Protection and Affordable Care Act, H.R. 3590. However, Speaker Pelosi and the House Democratic lead-ership did not have the votes needed to pass H.R. 3590 without changes. Thus, the House and Senate Democratic lead-ership began to pursue the budget rec-onciliation process to move healthcare reform legislation through Congress in two pieces. The White House and House and Senate Democratic leadership agreed on a two-step process in which the House would pass the Senate-approved healthcare reform bill and then vote on a pack-age of changes to the bill negotiated by Democrats in both chambers. Under budget reconciliation, the Senate would be able pass the package of changes with a simple majority vote. The provisions do not preclude CMS from including oral drugs without an injectable equivalent in the bundled payment system in 2011. With the Senate's commitment to pass the package of changes, the House approved H.R. 3590 by a vote of 219 to 212 on March 21. President Obama signed the Patient Protection and Affordable Care Act into law on March 23. Subsequent to President Obama signing H.R. 3590 into law, the House approved the reconciliation bill amend-ing H.R. 3590 by a vote of 220 to 211, sending the package of changes to the Senate. The Senate then voted 56 to 43, approving the reconciliation bill. However, before passing the bill, it omitted two provisions in the student loan section that were ruled non-germane by the Parliamentarian. The leg-islation had to be returned to the House for final approval before being sent to President Obama for his signature. The House cast the final vote on health-care reform legislation, 220 to 207, and approved the amended reconciliation bill. President Obama signed the recon-ciliation bill into law on March 30. With the President's signature, the end-stage renal disease (ESRD) provisions in the Senate bill became law. Under the new law, the one percent reduction to the ESRD market basket is eliminated and replaced by a productivity adjustment. The law also requires a Government Accountability Office (GAO) study of including oral drugs in the bundled pay-ment system and a report on Medicare beneficiary access to high-quality dialy-sis services. The study will include analysis of a provider's ability to furnish specified oral drugs, defined as a drug or biologic for which there is no injectable equivalent, or to arrange for the provi-sion of oral drugs and a provider's abil-ity to comply with State laws in order to furnish specifi ed oral drugs. The study will also evaluate wheth-er appropriate quality measures exist to protect beneficiary access to speci-fied oral drugs and other areas to be determined by the Comptroller General. The GAO report is required no later than March 23, 2011, one year from the enactment of healthcare reform. It is important for the kidney-care commu-nity to note that the healthcare reform provisions do not preclude the Centers for Medicare and Medicaid Services (CMS) from including oral drugs with-out an injectable equivalent in the bun-dled payment system in 2011. The final rule on the ESRD pro-spective payment system (PPS) has not been released. It is expected that CMS will issue a final regulation this spring, since the bundled payment system will replace the current payment system on January 1, 2011. The full impact of the bundled PPS on patients and providers is still unknown, and only time will tell if CMS agrees to delay the oral drug provisions until after the completion of the GAO study. The authors are with the Prime Policy Group based in Washington, DC." @default.
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- W1998593302 date "2010-06-18" @default.
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- W1998593302 title "Healthcare reform legislation signed into law" @default.
- W1998593302 doi "https://doi.org/10.1002/dat.20455" @default.
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