New Legislation Extends Coverage and Payment to IHS Facilities

On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, which extends coverage and payment to IHS facilities for certain services that had previously sunset on December 31, 2009.

Section 630 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) allowed IHS facilities to bill for other Part B services, which were not previously covered under Section 1848 of the Act, and expanded the scope of items and services for which payment would be made to IHS providers, suppliers, physicians, and other practitioners for a 5-year period beginning January 1, 2005.  As indicated in the Centers for Medicare & Medicaid Services’ (CMS) Change Request 6583, Section 630 ended on December 31, 2009. Section 2902 of the Patient Protection and Affordable Care Act indefinitely extends Section 630 of the MMA. The specific Part B services are:

  • Ambulance services
  • Clinical laboratory services
  • Part B drugs processed by the J4 A/B MAC and the DME MACs
  • Influenza and pneumonia vaccinations
  • Durable medical equipment
  • Therapeutic shoes
  • Prosthetics and orthotics
  • Surgical dressings, splints and casts
  • Screening and preventive services not covered prior to the implementation of §630

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