The House today approved a pared-back version of the American Jobs and Closing Tax Loopholes Act (H.R. 4213), which would prevent scheduled cuts to physician reimbursement rates under Medicare through 2011 and reduce Medicare payments to hospitals by about $4 billion. Dropped from this version of the legislation are provisions to continue special Medicaid assistance to states through June 2011 and to extend COBRA subsidies to laid-off workers. Taking the legislation up in two parts, the House voted 215-204 to extend expired tax breaks and federal unemployment benefits, and then voted 245-171 to block the 21% Medicare payment cut for physicians scheduled to take effect June 1 by providing a 2.2% rate increase for the rest of this year and an additional 1% increase in 2011. The AHA and other national hospital groups have expressed serious concern over the bill's payment reductions to hospitals, a result of changing Medicare's "72-Hour Rule." The change would prevent hospitals from submitting separate Medicare reimbursement claims for inpatient care and outpatient therapeutic care provided within three days of a hospital admission. The Senate is expected to consider H.R. 4213 after it returns from the Memorial Day recess June 7.