Congress unlikely to act on Medicare physician reimbursement reduction before midterm elections

[Sep 28, 2006]  Congressional leaders and physician groups have yet to reach an agreement on how to address a scheduled reduction in Medicare reimbursements to physicians, potentially signaling that "further action on the issue is likely to slip to November's lame-duck session," CQ HealthBeat reports. A 5.1% reduction in Medicare reimbursements to physicians is scheduled to take effect Jan. 1, 2007.

On Tuesday, American Medical Association officials rejected a Senate Finance Committee proposal that would have given physicians a 0.5% reimbursements increase in 2007, with an additional 1.5% increase in July 2007 for physicians who report quality data to the government.

Under the proposal, Medicare physician reimbursements would be reduced by an estimated 12% in 2009 and 13% in 2010 to compensate for the cost of the 2007 payments increases. Physician lobbyists said physicians mainly were unhappy with the proposed reductions in 2009 and 2010.

"This is just bumping costs back a couple of years," a lobbyist said. The House Energy and Commerce Health Subcommittee is scheduled to address the scheduled reduction in a hearing on Thursday, but the session "is not expected to alter" the lack of progress on the issue, according to CQ HealthBeat.

Lame-Duck Session
According to a Finance Committee aide, committee Chair Chuck Grassley (R-Iowa) "was trying to address the doctors' problem in 2007 in a way that was feasible now given that doctors might not get anything in the lame-duck" session, which begins Nov. 13.

Grassley "will continue to work on it," the aide said (Carey, CQ HealthBeat, 9/27). Sen. Jon Kyl (R-Ariz.), speaking on Wednesday at a rally sponsored by the American Academy of Physicians, said, "[I]f we work hard ... we can actually have a positive update for the year 2007."

 Kyl noted that 80 Senators have signed a letter in support of reversing the cut, adding, "I believe we will be successful in that effort." Kyl said he believes Congress will pass legislation on the matter during the lame duck session but did not give specific information on the progress of discussions (Talbott/Lee, CongressDaily, 9/27).

Jack Lewin, CEO of the California Medical Associationn, said, "I think doctors have to just recognize that they are low on the priority system of Congress despite all the rhetoric, and that the leadership is willing to just walk away. I'm telling doctors here that the lame-duck session is very unlikely to solve this problem or even to put a Band-Aid on it, and that the cuts are going to go into effect in January."

CQ HealthBeat, 9/27).

Letter
"With physician shortages looming and millions of baby boomers nearing the age of Medicare eligibility, it is unwise to arbitrarily cut Medicare payments to doctors and make it harder for them to continue to treat Medicare patients," William Plested, president of AMA, writes in a letter to the editor of the Washington Postt

Plested adds, "Eighty U.S. senators and 265 representatives have called on congressional leaders to stop the cuts to Medicare payments before Congress adjourns, but no action has been taken." He concludes, "Congress must prevent these cuts and tie payments to increases in practice costs to preserve the access of seniors to health care" (Plested, Washington Postt, 9/28).

Home Health Care Providers
In related news, the National Association of Home Care and Hospice, which represents home health care providers, "is enlisting the support of lawmakers in an effort to discourage Congress from eyeing cuts to their payments as a way to offset other Medicare expense," The Hill reports.

According to The Hill, 76 senators sent a letter this month to Grassley and Finance Committee ranking member Max Baucus (D-Mont.) in support of increasing Medicare reimbursements to home health care providers to help cover providers' rising expenses.

NAHC President Val Halamandaris in a recent statement said, "Some policymakers may even be tempted to use savings in home care as a means of canceling the 5% [reduction in Medicare] payments to physicians. ... Trading home care for physician payments would be a terrible bargain" (Young, The Hill, 9/28).