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'Doc fix' extension in the works, Hill staffers say

Leaks out of Capitol Hill strongly suggest there'll be a Doc Fix 2 by Friday -- this one for 10 months. As for how Congress will pay for it, well...

The 10-month, through-end-of-2012  figure is cited so far by the National JournalThe HillDOTmed, and others, and seems solid. 

To pay for it, or at least pretend to pay for it, a cluster of program and provider cuts have been mentioned by tip sheets and news services. The ones getting the most mention:

Physicians Practices: Goodbye to "mental health add-on payments and a provision of the health law that increased payments for bone density scans," says The Hill.

Hospitals, SNFs, home health: CNN reports "cuts to Medicare hospital and specialist fees that would not impact patients, according to the congressional aides." 

AlterNet elaborates: "Medicare payment cuts for home health services, hospital bad debt, and reductions in existing pay bumps for hospitals that have many low-income patients." (DSH?)

This seems to indicate that Medicare and Medicaid bad debt policies for hospitals and SNFs -- which are not generous to providers as it is -- will get even worse.

The Hill mentions that "two other programs - Section 508 hospitals and special pathology payments - would be phased out."

"Better accountability": Modern Healthcare says committee Republicans got better-accountability promises (for whatever they're worth), such as "extending and reforming the therapy cap exception process by requiring greater accountability."

ACA programs: The Prevention and Public Health Fund, mandated by the Affordable Care Act, a general-welfare fund administered through state governments, is probably going to be cut hard. And it probably won't be the only ACA-related cut, since a.) Republicans hate ACA and b.) it's huge, so there's a lot to give away there.

More as we hear it.

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