Senate Postpones Vote on Fixing Medicare Doc Pay;
Medicare Officials Easy Up on Insurers
More details emerging on changes to Medicare in
health care reform proposals
Oct. 19, 2009 - Senate Democrats have postponed a
scheduled cloture vote today on a bill that would make permanent changes
to scheduled rate cuts to Medicare reimbursement for doctors and
hospitals. Meanwhile, doctors worry about the cuts and lawmakers worry
that the fix could break budget goals.
The
New York Times Prescriptions Blog reports that the American Medical
Association is broadcasting a new television commercial endorsing the
Senate bill.
"S. 1776 is a Senate bill that would permanently
adjust a Medicare payment formula that for years has threatened to
impose steep annual cuts in the rates that doctors are paid," according
to the Times.
"The formula, tracing to laws passed in 1989 and
1997, was devised to keep Medicare spending in check." In recent years,
though, congressional lawmakers have intervened with a "patch, known on
Capitol Hill as the annual 'doc fix,' to prevent the cuts."
Currently, Democrats have no plans "to offset the
cost of S. 1776, which is why they are eager to keep it separate from
the broader health care legislation and avoid breaking the president's
promise [that health reform would not add to the deficit]."
They insist "fixing the doctor payment formula
should not count toward the cost of the big health care legislation,
because it is a problem they inherited. What they have trouble
explaining, though, is how the flawed formula is different from any of
the zillion other entrenched problems in the health care system that the
proposed overhaul aims to fix" (Herszenhorn, 10/18).
The Hill Blog reports on the decision to postpone today's vote:
"Initially, Senate Majority Leader Harry Reid (D-Nev.) scheduled his
motion to end floor debate and bring the so-called 'doc fix bill' to a
final vote at the beginning of next week.
But the leader reportedly changed his mind on
Friday, deciding instead to he would vitiate Monday's vote so both
parties' lawmakers could broker an agreement on a few remaining
amendments, his office said Sunday.
Reid's office did not specify what those
amendments might be, but Republicans have previously suggested they
hoped to add pay-fors to the Democrats' bill in an attempt to reduce its
$248-billion footprint. ... Nevertheless, it is unclear when Democrats
will attempt cloture next, but it could be as soon as later this week" (Romm,
10/18).
► Medicare Officals Back Away From Hard Line
Stance on Insurers' Warning Letters
The New York Times reports: "The Obama administration on Friday
backed away from an order that had prohibited insurance companies from
warning Medicare recipients about the possible loss of benefits under
pending legislation to overhaul the health care system."
A political storm was triggered last month when
they tried to stop such communications.
"Under new guidelines, insurance companies can
communicate with Medicare beneficiaries on pending legislation, provided
they do not use federal money to do so. In addition, insurers must get
permission from beneficiaries before sending them information about
legislation or asking them to join grass-roots advocacy efforts."
But also on Friday, "the Obama administration cited
Humana ... for violation of Medicare rules, saying the company had
misled beneficiaries by telling them they could lose valuable benefits
under the legislation being pushed by President Obama and Democrats in
Congress. The actions on Friday were the latest skirmish between the
Obama administration and the insurance industry" (Pear, 10/16).
► More Details Emerging On Health Reform's
Proposed Changes To Medicare
The Dallas Morning News reports on some of health reform's
proposed changes to Medicare and local consumer reactions.
"The 10.4 million beneficiaries with private
insurers' Medicare Advantage plans will still get coverage at least
comparable to regular Medicare, but some will see fewer extra benefits
or higher out-of-pocket costs. For most of Medicare's 45 million
beneficiaries, an overhaul will improve coverage by beefing up drug
benefits, preserving access to physicians, paying for more preventive
care and putting Medicare on firmer financial footing."
Seniors have expressed concern about Medicare
changes, especially the $500 billion in proposed savings, while the
Obama administration and AARP have tried to reassure them.
"Part of that $500 billion will come from more
aggressively attacking waste and fraud, while other savings will come
from giving providers such as hospitals and home health care agencies
less of an increase each year.
The nation's hospitals agreed this summer to
contribute $155 billion over 10 years toward the cost of insuring the
uninsured, about $100 billion of which will come from
lower-than-expected Medicare and Medicaid payments.
With more patients insured, hospitals are banking
on less uncompensated care. Though they won't receive as much as they
had hoped to treat Medicare patients, the hospitals will now get paid
for previously uninsured younger patients" (Moos, 10/18).
The Christian Science Monitor reports on proposed changes to
Medicare: "The White House and congressional reformers call it 'savings'
a move to reward quality care, rather than quantity of services
provided, more efficiency, and less waste. The nonpartisan Congressional
Budget Office estimates that the Senate Finance Committee's proposed
bill will generate $404 billion in savings [over 10 years], mainly
through reductions in Medicare's payment rates in the fee-for-service
sector and reining in the popular Medicare Advantage program.
But there's a catch: Congress has to muster the
political will to enforce these cuts over time and lawmakers have shown
little heart for it, especially when it means riling the powerful
seniors lobby" (Chaddock, 10/17).
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