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Medicare News
Docs Still Face Medicare Pay Cut as Congress Winds
Down Without Agreement
Veterans stuck too in fight for more health care
funding
 December 8, 2006 – Certainly this last day of the
lame-duck Congress will continue into the weekend, but as of late Friday
the physicians still do not have a vote on the bill that would stop a
5.1 percent pay cut by Medicare that is to become effective on January
1. The House was expected to vote today on HR 6408 but it had not
reached the floor by 5 p.m. And, too, it would still require Senate
action. Many physicians are predicting senior citizens will have a more
difficult time finding a doctor that will accept Medicare patients, if
the pay cut stands. Senate Budget Committee Chair Judd Gregg (R-N.H.)
said that he opposes the bill but that he expects the legislation to
pass. "They bought the votes."
 Congress
to Vote on Bill to Reverse Scheduled Reduction in Medicare Physician
Reimbursements
House leaders on Friday plan to hold a vote on a
bill (HR
6408) that includes the reversal of a scheduled reduction in
Medicare physician reimbursements, but "passage in the Senate is not a
certainty" because of disagreements over other provisions, CongressDaily
reports (Vaughan/Johnson, CongressDaily, 12/8).
Medicare physician reimbursements will decrease by
5.1% in January 2007 without congressional action during the lame-duck
session, which likely will end this week (Kaiser
Daily Health Policy Report, 12/7).
The bill would maintain the current level of
Medicare physician reimbursements and would provide a 1.5% increase in
reimbursements to physicians who agree to report data on certain
quality-of-care measures.
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Cost of HR 6408 |
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The Congressional Budget Office
(CBO) and the Joint Committee on Taxation (JCT) have reviewed
the provisions of H.R. 6408, the Tax Relief and Health Care Act
of 2006, as introduced on December 7, 2006.
That bill includes provisions
that would make numerous changes in the tax code and in the
Medicare program, provide for additional offshore oil and gas
leasing in the Gulf of Mexico, and increase health care benefits
for retired miners, as well as a number of other provisions.
CBO and JCT estimate that
enacting the bill would increase outlays by $4.8 billion and
reduce revenues by $34.7 billion over the 2007-2011 period. Over
the 10-year period 2007-2016, outlays would rise by $10.4
billion and revenues would decline by $38.8 billion. |
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The legislation would remove $6.5 billion from a
stabilization fund established under the 2003 Medicare law to help cover
the cost. Congress established the stabilization fund to encourage
health insurers to offer Medicare prescription drug plans in underserved
areas.
In addition, the bill would reduce the maximum
allowable rate at which states can tax Medicaid providers to 5.5% from
6%, a move that would decrease federal matching funds to states, to help
cover the cost (Armstrong, CQ Today, 12/7).
Among other provisions, the legislation also would
provide $4 billion for the Abandoned Mine Land fund to help cover the
cost of health benefits of retired coal mine workers and $1 billion to
expand the use of health savings accounts (Vaughan/Johnson,
CongressDaily, 12/8).
The bill does not include a provision proposed by
the
Senate Finance
Committee that would have redistributed to states unspent
SCHIP funds from 2004 and 2005.
Other Medicare Provisions
In addition to the reversal of a scheduled reduction in Medicare
physician reimbursements, the bill includes a number of other provisions
related to the program. The legislation would:
● Extend for one year an exceptions process for
Medicare therapy services;
● Provide a 1.6% increase in Medicare
reimbursements to dialysis facilities;
● Continue direct Medicare billing for the
technical component for pathology services performed by independent
laboratories, rather than hospitals;
● Restore Medicare hospital wage index
reclassifications that have expired and require the Medicare Payment
Advisory Commission and CMS to issue reports on the wage index;
● Provide a full Medicare reimbursement update to
hospital outpatient and ambulatory surgical facilities that agree to
report data on certain quality-of-care measures before 2009;
● Identify and collect inaccurate Medicare
overpayments and underpayments by specialized contractors;
● Provide disproportionate share reimbursements
for FY 2007 to Tennessee and Hawaii; and
● Establish a Physician Assistance and Quality
Initiative Fund available to finance future Medicare physician
reimbursement and quality improvement proposals (CQ
HealthBeat, 12/7).
Comments
Senate Majority Leader Bill Frist (R-Tenn.) on Thursday said that
the legislation might "face obstacles" in the Senate and that he will
work with senators to find "the smoothest path" for passage.
Senate Finance Committee Chair Chuck Grassley
(R-Iowa) and ranking member Max Baucus (D-Mont.) in a joint statement
said they support the legislation. Grassley said, "This is a good
agreement. It stabilizes access to doctors for Medicare beneficiaries,
(and) it moves Medicare toward linking payment with quality" (CQ Today,
12/7).
Senate Budget
Committee Chair Judd Gregg (R-N.H.) said that he opposes the
bill but that he expects the legislation to pass. "They bought the
votes," Gregg said, adding that the bill was "500 pages long and $40
billion over budget" (Vaughan/Johnson, CongressDaily, 12/8).
The
American Medical
Association in a statement said, "We appreciate the
bipartisan efforts by the House and Senate. ... If this legislation
passes, we will need to work with the 110th Congress to address issues
regarding the quality reporting framework" (CQ Today, 12/7).
Mohit Ghose, a spokesperson for
America's Health
Insurance Plans, said that the effect of the provision in the
bill that would remove $6.5 billion from the stabilization fund remains
unclear. AHIP "will continue to advocate with the
HHS
secretary to make sure that any changes in the payment structure in
Medicare do not adversely affect the millions of beneficiaries who are
seeing lower out-of-pocket costs and better benefits through Medicare
Advantage plans," Ghose said.
According to Robert Greenstein, executive director
of the
Center on Budget
and Policy Priorities, the legislation should have included
the provision to redistribute to states unspent SCHIP funds from 2004
and 2005, a move that would have ensured as many as "600,000 low-income
children keep their health insurance" (CQ HealthBeat, 12/7).
Veterans Seek More Funding for Health Care
In other congressional news, lawmakers on Thursday night planned to
file a continuing resolution that would fund operations for most federal
agencies until Feb. 15, 2007, CongressDaily reports. The current CR will
expire on Friday (Cohn, CongressDaily, 12/8).
Congress has passed only two of 11 appropriations
bills for FY 2007. In most cases, a CR funds federal agencies at the
lowest level among House-passed, Senate-passed or prior-year levels.
However, veterans groups "have made a vigorous
lobbying effort to obtain more funding for veterans' health," and Senate
Appropriations
Subcommittee on
Military Construction and Veterans Affairs and Related Agencies
Chair Kay Bailey Hutchison (R-Texas) said she plans to introduce an
amendment to the CR to increase funds for health care and other services
for veterans and active duty soldiers.
Veterans groups have sought an additional $3
billion in funds, but the CR "is not expected to contain the full $3
billion," CQ Today reports (Higa, CQ Today, 12/7).
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