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Medicare News
Congress Nears Agreement on Stopping Medicare's
Reduction of Physician Pay
Action needed today
if it is to happen before cut kicks in
December 7, 2006 – There appears to be little doubt
this morning that the lame-duck Congress will set aside the pay cut for
doctors that has been mandated by Medicare. Physician reimbursements
will decrease by 5.1% on January 1, without the Congressional override.
Doctors appear to be sincerely concerned about this pay cut, which will
be more than 5.1% in some cases.
An ophthalmologist told SeniorJournal.com his pay
reductions would amount to 8%. The American Medical Association says
their surveys show many doctors will refuse new Medicare patients, due
to the low pay levels, but many have rejected this, since it has been
used several times in recent years, without much reduction in Medicare
participation by physicians. This time, however, physicians are
privately saying it may be for real.
The majority of lawmakers tend to be favoring
reducing the reimbursement reduction but have been arguing over how
Medicare can make up the money - $10.5 billion over five years.
KaiserNetwork.org Daily Report
Lawmakers Closer to Agreement on Medicare
Physician Payments
House and Senate leaders have agreed to use a
stabilization fund established under the 2003 Medicare law to help
finance the reversal of a Medicare physician reimbursement reduction
scheduled to take effect on Jan. 1, 2007, but remain divided on other
provisions, CongressDaily reports (Vaughan/Johnson, CongressDaily,
12/7).
 Medicare
physician reimbursements will decrease by 5.1% without congressional
action during the lame-duck session, which likely will end this week.
Congress established the stabilization fund 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 (Kaiser
Daily Health Policy Report, 12/6).
On Wednesday,
Senate Finance
Committee Chair Chuck Grassley (R-Iowa), committee ranking
member Sen. Max Baucus (D-Mont.) and
House Ways and
Means Committee Chair Bill Thomas (R-Calif.) agreed to
include a reversal of the Medicare physician reimbursement reduction in
a bill that also includes tax cut extensions and trade policies and
energy policies (CongressDaily, 12/7).
Senate Majority Leader Bill Frist (R-Tenn.) on
Wednesday said, "I feel we will have a single product that we can take
through" both the House and Senate during the lame-duck session.
Some Disagreements Remain
However, "Thomas remained at odds with Grassley and Baucus over the
terms of the Medicare payment fix," CQ Today reports. The Senate Finance
Committee has proposed to freeze the Medicare physician reimbursement
reduction for one year and provide physicians who participate in a new
quality reporting program a 1.5% increase in July 2007.
According to Senate aides, the proposal includes an
update to the baseline for Medicare reimbursements in future years, a
provision not included in Thomas' proposal (Van Dongen, CQ Today, 12/6).
In addition, the proposal from the committee
includes other health care provisions not included in the proposal from
Thomas -- such as a redistribution of funds to SCHIP, a maximum rate of
5.5% that states could tax Medicaid providers, transitional medical
assistance for individuals who lose Medicaid eligibility, and a
requirement that federal agencies have access to all Medicare Advantage
and Medicare prescription drug plan data submitted to CMS (Carey,
CQ HealthBeat,
12/6).
VA Appropriations
In other news, Congress likely will approve a continuing resolution
to finance operations for most federal agencies until Feb. 15, 2007,
that includes additional funds for the
Department of
Veterans Affairs, CongressDaily reports.
Under the resolution, which Congress likely will
approve on Thursday or Friday, VA would not receive the 12% increase in
funds proposed under the fiscal year 2007 Military Construction-VA
appropriations bill.
However,
House
Appropriations Committee Chair Jerry Lewis (R-Calif.) has
agreed to an exemption that would provide VA with "unprecedented
flexibility to transfer funds to cushion medical services accounts,"
CongressDaily reports (Cohn, CongressDaily, 12/7).
Rep. James Walsh (R-N.Y.), chair of the House
Appropriations
Subcommittee on
Military Quality of Life and VA and Related Agencies, said
the resolution would allow VA to transfer as much as $650 million and to
use an additional $590 million in unspent funds (Higa/Dennis, CQ Today,
12/6).
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