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Senior Citizen Politics
Medicare Reform Hits Snag as Administration
Threatens Veto if Physician Pay Cut is Reduced
Medicare reform hits snag; Health groups want
Medicare physicians to use electronic prescribing or face financial
penalties
 Dec. 6, 2007 The Medicare reform package be
shaped in the Senate Finance Committee hit a snag yesterday and the
Democratic chairman says he needs to consult with House Democrats before
proceeding on the legislation. A major piece of the plan is to roll back
the 10 percent pay cuts for doctors that Medicare is set to enforce for
2008. Republicans on the committee were fighting for a short-term roll
back of the cut when a letter suddenly appeared from the Health and
Human Services Secretary that threatened a Bush veto under certain
conditions.
Senate Finance Committee Chair Baucus Cancels
Medicare Bill Mark Up, Will Negotiate With House Democrats
Senate Finance Committee Chair Max Baucus (D-Mont.) on Wednesday
canceled plans for a mark up of Medicare legislation and instead will
negotiate directly with House Democrats on the measure,
CQ HealthBeat reports. The bill would block a 10% cut in Medicare
physician fees.
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According to CQ HealthBeat, Baucus has "struggled"
with committee Republicans over whether to block the physician cuts for
one year or two years, as well as on reductions to Medicare Advantage
payments to help fund the physician fee fix. Baucus canceled a mark up
one day after the Bush administration threatened to veto any bill that
includes cuts to MA plans (CQ HealthBeat, 12/5).
HHS Secretary Mike Leavitt on Tuesday in a letter to the Finance
Committee wrote that a veto would be recommended for any bill that
"results in a loss of access to health care services, benefits or
choices" in the MA program; "raises taxes ... to fund spending
increases"; or alters Medicare's fiscal status by overturning
administration regulatory decisions (Kaiser
Daily Health Policy Report, 12/5). (Read text of Leavitt
letter below this news story.)
Finance Committee ranking member Chuck Grassley
(R-Iowa) on Wednesday said of the veto threat: "What they're really
saying is, 'We don't care if the doctors take a 10% cut'" (CQ
HealthBeat, 12/5).
E-Prescribing
A coalition of health care and consumer groups
announced support for legislation that would require Medicare physicians
by 2011 to use electronic prescribing or face financial penalties, CQ
HealthBeat reports. The bill's sponsors include Sens. John Kerry
(D-Mass.), Debbie Stabenow (D-Mich.) and John Ensign (R-Nev.), and Reps.
Allyson Schwartz (D-Pa.) and Jon Porter (R-Nev.).
Bill Vaughan, senior policy analyst at
Consumers Union, on Wednesday in a letter to the Senate wrote that
the group wants Congress to implement e-prescribing in Medicare and
Medicaid and called for the legislation to be included in the Medicare
package. The e-prescribing measure would provide physicians with a bonus
for each e-prescription written and provide funding for start-up costs
associated with adopting the technology. It also would authorize the HHS
secretary to provide physicians with one- or two-year hardship waivers
if they have difficulty acquiring the technology.
The Bush administration has asked that health
information technology adoption requirements be included in any Medicare
legislation that would prevent a physician fee cut.
Kerry said, "E-prescribing will save money, save
time, save doctors from piles of paperwork and, most importantly, save
lives," adding, "Deaths and injuries from handwritten prescriptions
could be nearly eliminated if e-prescriptions were adopted on a wide
scale. We need to seize this bipartisan opportunity and make this
common-sense reform a reality now" (Carey, CQ HealthBeat, 12/5).
Secretary Leavitt Letter to Senators on Medicare
Physician Payment Legislation
Text of letter sent to Sen. Max Baucus, chairman,
and Sen. Charles Grassley, ranking Republican, on Senate Finance
Committee
We understand the Senate Finance Committee soon
intends to consider draft legislation to block the upcoming statutorily
mandated reduction in payments to physicians under the fee-for-service
Medicare program. As you know, this 10 percent cut would otherwise occur
on January 1, 2008. I write to reiterate the Administration's commitment
to strengthen and improve Medicare, and to ensure our Nation's seniors
continue to have access to, and choices among, high-quality benefits
through this important program.
The Administration looks forward to working with
Congress on appropriately offsetting legislation to mitigate the cut to
physician reimbursement rates under Medicare. To that end, we ask that
Congress adhere to the following principles for an update to the
physician fee schedule.
Such a bill should:
● Pay for any adjustment to the physician fee
schedule formula by responsibly adjusting payments to other providers in
the fee-for-service Medicare program.
● Bear in mind the impact on beneficiary
premiums of potential increases in Part B spending for physicians, when
considering appropriate offsets.
● Condition receipt of a portion of any fee
adjustment to adoption of certified electronic health information
technology. Physicians who do not adopt appropriate, available
technology should receive a lower payment than those who do.
● Implement payment policies to ensure patients
receive high-quality care in the most medically appropriate and
efficient setting without increasing costs for taxpayers or for Medicare
and its beneficiaries.
Conversely, the President's senior advisors would
recommend a veto of any bill that:
● Raises taxes on the American people to fund
spending increases.
● Results in the loss of access to health care
services, benefits, or choices in the Medicare Advantage program,
through which nearly 20 percent of seniors and Medicare beneficiaries
with disabilities currently receive their benefits.
● Disturbs, undermines, or overturns the many
successes of the new Medicare prescription drug benefit.
● Undermines efforts to promote fiscal solvency
in the Medicare and Medicaid programs. For example, legislation should
not repeal the Medicare funding warning or erode the programs' fiscal
integrity by overturning regulatory policies developed by the
Administration.
We look forward to working with you to produce
legislation that the President can sign into law. The Office of
Management and Budget advises that from the standpoint of the
Administration's program, there is no objection to the transmittal of
this letter.
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