Medicare Cost Contract Extension and Refinement Act of 2009 - Amends title XVIII (Medicare) of the Social Security Act (SSA) with respect to reasonable cost reimbursement contracts with qualified health maintenance organizations (HMOs) or competitive medical plans for Medicare reimbursement of hospitals and skilled nursing facilities (SNFs).
Extends until January 1, 2013, the period during which such reasonable cost reimbursement contracts can remain in the market.
Revises conditions for approval of an application for a modification to a reasonable cost contract to expand the contract's service area.
Applies to extended or renewed reasonable cost contracts certain requirements under Medicare part C (Medicare Advantage).