|
Weekly Healthcare Reform Update
21.2
percent payment cut looms; Senate healthcare debate continues
Unless
Congress intercedes, Medicare reimbursement rates will be cut 21.2 percent
on Jan. 1. The Medical Group Management Association (MGMA) and other physician
organizations have been in discussions with the administration and
congressional leadership to prevent the cut from taking effect. MGMA has
communicated its support for a short term (30-45 day) temporary physician
payment “bridge” mechanism to allow congress to work on a permanent
solution to the sustainable growth rate (SGR) formula. Whether this
short-term mechanism freezes Medicare payment rates at the current level or
provides a modest increase has yet to be determined.
MGMA has
consistently expressed opposition to any attempt to implement another one-
or two-year delay in addressing the SGR problem, since such a delay would
only add to the long-term cost of permanently repealing the flawed formula.
The most likely legislative vehicle to provide the necessary congressional
action would be adding this short term “bridge” mechanism to the FY 2010
Department of Defense Appropriations bill, which the House is likely to
consider later this week.
As the
Senate entered its third consecutive week of debate on healthcare reform
legislation, prospects for passage in that chamber before Christmas
appeared to dim. To date, more than 300 amendments have been introduced,
but the Senate has formally considered only 16 of them and approved only
six. Of note, the Senate rejected an amendment by Sen. John Ensign, R–Nev.,
to limit attorney’s fees in medical malpractice cases. The amendment was
defeated by a vote of 66-32.
The
Senate spent much of the last few days debating an amendment by Sen. Byron
Dorgan, D-N.D., to allow Americans to import prescription drugs from other
countries. Despite some safety concerns, the drug importation amendment has
significant bipartisan support and is the pending business on the senate
floor as members return to work today.
Last
week, a group of 10 Democratic senators announced that they had reached
agreement on a set of potential alternatives to amend the bill originally
crafted by Senate Majority Leader Harry Reid, D-Nev.
This new
proposal was intended to close the gap in the Democratic caucus between
those who support a public option and those who have stated their
opposition to any final legislation that includes a public option
provision. In addition to the public option issue, this group of senators
discussed creating a new section of the bill that would allow those aged
55-64 who currently are without insurance to “buy-in” to the Medicare
program. MGMA and other physician and hospital associations have
consistently opposed any expanded patient population where providers are
reimbursed at Medicare rates.
This new
“compromise” proposal was sent to the Congressional Budget Office (CBO),
the official scorer for Congress, to determine the impact on the overall
cost of the legislation if these changes to the bill were adopted. An
official score was expected early in the week of Dec. 14. However, even if
the CBO score is deemed favorable, Reid will still have a difficult task
obtaining final passage of healthcare reform by Christmas, since he will
more than likely need to overcome three Republican filibusters – on a
manager's amendment, a substitute amendment and the bill itself.
|
