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The Tax Equity and Fiscal Responsibility Act of 1982 (), also known as TEFRA, is a United States federal law that rescinded some of the effects of the Kemp-Roth Act passed the year before. As a result of ongoing recession, a short-term fall in tax revenue generated concern over the budget deficit. TEFRA was created in order to reduce the budget gap by generating revenue through closure of tax loopholes and introduction of tougher enforcement of tax rules, as opposed to changing marginal income tax rates. TEFRA was introduced November 13, 1981 and was sponsored by Representative Pete Stark of California. After much deliberation, the final version was signed by President Ronald Reagan on September 3, 1982. ==Summary of provisions== The Act includes certain provisions related to the US Health Care System. The Act: * Established the prospective payment system for inpatient hospital care using the Diagnosis-related group (DRG) Coding system * Established authority for certain payments for hospice care〔(Medicare Benefit Policy Manual Chapter 9 - Coverage of Hospice Services Under Hospital Insurance ) on cms.gov〕 * Recognized Medicare as the "secondary payer" for health services to individuals covered by another private health insurance plan * Established the provisions for Utilization Review as "....reviews of the pattern of quality of care, in an area of medical practice where actual performance is measured against, objective criteria which define acceptable and adequate practice" * Allowed for the contracting of health maintenance organizations to provide services to Medicare recipients (Part C of Medicare) The Office of Tax Analysis of the United States Department of the Treasury summarized the tax changes as follows:
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