A clarification: Under H4452 providers would receive “110 percent of the Medicare reimbursement rate for those services as if they were rendered to a Medicare beneficiary not taking into consideration any beneficiary cost sharing.” The Medicare payment rate less the patient co-payment/deductible is considerably less than charges.

My understanding is that Medicare pays well for inpatient services, particularly complex inpatient services, but less well for outpatient services. Nationally, Medicare paid 90% of all provider costs in 2008 (according to the AHA chartbook), so 110% of Medicare rates would approximate the national average of provider costs.