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Medicare News

Lame-Duck Congress Still Wrestling with How to Reverse Medicare's Proposed Pay Cut for Doctors

December 6, 2006 – The long and costly battle over Medicare proposed cut in pay to physicians was expected to be settled in this lame-duck session of Congress but it has hit a snag – how to make up for the lost funds if the 5.1% pay cut is reversed. Leaders in the House and Senate seem unable to find common ground. The doctors argue that cutting Medicare reimbursements will make it more difficult for senior citizens to find a doctor that will accept Medicare patients. Other studies disagree.

Click here to the Daily Health Policy Report - KaiserNetwork.orgHouse, Senate Leaders Debate Proposals To Finance Reversal of Medicare Physician Reimbursement Reduction

House and Senate leaders on Tuesday "struggled" to reach an agreement on a proposal to finance the reversal of a Medicare physician reimbursement reduction scheduled to take effect on Jan. 1, 2007, CQ HealthBeat reports (Reichard, CQ HealthBeat, 12/5).

 

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December 6, 2006 – The final days of this Congress are seeing considerable focus on Medicare issues. A group of senators have asked Health & Human Services to make diabetes screening and prevention a "top priority" for Medicare. Tomorrow, the House Ways and Means Committee will consider Medicare's coverage of anemia medication used to treat patients with end-stage renal disease. And, outside Congress, a meeting of advocates expressed their desire to see "patient-centered care" linked to Medicare reimbursements with pay-for-performance measures. Read more...

Medicare Final Rule Cuts Physician Pay Five Percent for 2007

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November 3, 2006 – The 5.1 percent cut in pay for physicians in 2007 proposed by Medicare has been reduced to something closer to 5 percent, according to the final rule issued by the Centers for Medicare & Medicaid Services this week. The war may not be over, however, since the American Medical Association was still pressing Congress to override the pay cut when they took their election recess. (See AMA reaction in sidebar.) Read more...


Read the latest news on Medicare or Medicare Drug Program

 

Medicare physician reimbursements will decrease by 5.1% without congressional action during the lame-duck session, which likely will end this week (Kaiser Daily Health Policy Report, 12/5).

According to CQ HealthBeat, a Senate aide indicated that a "major" disagreement between House and Senate leaders involved a proposal to use a "much bigger physician payment cut in 2008" to finance the reversal of the reduction in 2007.

 House Ways and Means Committee Chair Bill Thomas (R-Calif.) has proposed a Medicare physician reimbursement reduction of at least 10% in 2008 to finance the reversal of the reduction in 2007, but Senate Finance Committee Chair Chuck Grassley (R-Iowa) and ranking member Max Baucus (D-Mont.) oppose the proposal, according to the Senate aide.

Senate Budget Committee Chair Judd Gregg (R-N.H.), who also opposes the proposal, said, "Things like that are just accounting gimmicks" (CQ HealthBeat, 12/5).

Baucus said that he and other lawmakers "are looking closely, aggressively" at a proposal to eliminate a stabilization fund established under the 2003 Medicare law to encourage health insurers to offer prescription drug plans in underserved areas to help finance the reversal of the physician reimbursement reduction.

Elimination of the stabilization fund would offset an estimated $5.8 billion of the $10.5 billion cost over five years of the reversal of the Medicare physician reimbursement reduction (Vaughan/Johnson, CongressDaily, 12/6).

Other Disagreements
House and Senate leaders also disagree on whether to attach other health care provisions to legislation that would reverse the Medicare physician reimbursement reduction.

The House on Tuesday "appeared ready to move" on a bill that would only reverse the Medicare physician reimbursement reduction, "while the Senate was putting together an $18 billion take-it-or-leave-it offer that would also provide for increased payments to rural doctors, hospitals and home care agencies," according to a lobbyist, CQ HealthBeat reports.

The Senate bill also would provide Medicaid funds for individuals who leave welfare and would reverse a scheduled reduction in Medicare rehabilitation services reimbursements.

The House and Senate likely will finalize legislation that would reverse the Medicare physician reimbursement reduction on Wednesday, CQ HealthBeat reports (CQ HealthBeat, 12/5). However, passage in Senate, which likely will include the legislation in larger tax bill, "is far from assured," CongressDaily reports (CongressDaily, 12/6).

 

"Reprinted with permission from kaisernetwork.org You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2006 Advisory Board Company and Kaiser Family Foundation. All rights reserved.”

 

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