On December 18, the Senate passed the Medicare, Medicaid, and SCHIP Extension Act of 2007 (S 2499) by unanimous consent on December 18. Under suspension of the Rules on December 19, 2007, the House of Representatives passed by a vote of 411 to 3 a Medicare-Medicaid SCHIP bill. The legislation now will be sent to President Bush to sign. The bill was limited in scope in order to secure swift passage in the both chambers and ensure the President's approval.

The 75% Rule relief provisions of S 543 and HR 1459 are included in the final Medicare package. The provision provides permanent relief at 60% compliance threshold effective July 1, 2006, and enables hospitals to count comorbidities. The relief will be paid for through a market basket freeze from April 1, 2008, through September 30, 2009.

The medical necessity provision did not make it into the final package. The onerous hips and knees and hip fracture cuts were rejected. The bill also includes extension of the exceptions process for therapy caps and relief for long-term acute care hospitals.