Daschle, Hastert Hope To Pass Medicare Provider ‘Giveback’ Package
Senate Majority Leader Tom Daschle (D-S.D.) yesterday said that although he would "like to be able to pass" the Medicare "giveback" bill introduced by Sens. Max Baucus (D-Mont.) and Charles Grassley (R-Iowa), the package only has a "50-50" chance of passage, CongressDaily/AM reports (Rovner, CongressDaily/AM, 10/4). The 10-year, $43 billion package includes "smaller-than-planned" cuts for hospitals and increases in payments for rural physicians, hospitals and home health agencies. Medicare+Choice plans would receive a boost in payments of 4% in 2003 and 3% in 2004. The bill also would reverse the expiration of $1.7 billion in temporary Medicare funding for nursing homes that expired Oct. 1. In addition, the package would expand a pilot program that uses competitive bidding for durable medical equipment nationwide. The plan also includes a provision that would allow Medicare to cover immunosuppressive drugs for organ transplants and would renew a five-year program that helps low-income seniors pay their Medicare premiums. The plan includes a two-year delay of payment caps for physical and occupational therapy and would expand coverage of cholesterol and lipid level tests. The package also includes additional funding for state Medicaid and CHIP programs (California Healthline, 10/3). The House in July passed its own giveback package as part of a bill that also included a prescription drug benefit. Speaker Dennis Hastert (R-Ill.) said he "hoped to complete work on a bill" before the session ends, CongressDaily/AM reports.
However, CMS Administrator Tom Scully said the administration believes the giveback bill may not be "appropriate." He added the administration's two main concerns for a giveback package are changing the physician payment formula to prevent a 4.4% cut scheduled for Jan. 1 and renewing states' ability to use unspent CHIP funds. "Our general strategy is physician payment has to be fixed," adding, "The SCHIP issue ... we certainly have to fix that. We don't see a driving need for other things" (CongressDaily/AM, 10/4).
Testifying before the House Ways and Means Subcommittee on Health yesterday, Scully told lawmakers that if Congress does not address a "problem" with average wholesale prices, which the government uses to get prescription drug reimbursements under Medicare, the administration will move to "fix" the problem within the next six months, CongressDaily/AM reports. He says the problem is forcing the government to pay excessive prices for certain medications that are covered by the program. Legislators have said they would address the issue, but they have not agreed on how to ensure Medicare payments reflect actual costs and not the "inflated published prices to which payment is currently pegged." Scully endorsed adopting a competitive bidding model for Medicare drug prices, adding that if Congress does not reach an agreement, he would select one of Medicare's private insurers to choose a "reference price" for all drugs covered by the program. Although such a system could save Medicare "an immediate $100 million," Scully said it would be better to determine what drugs actually cost, which "could save $500 million" (Rovner, CongressDaily/AM, 10/4).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.