House Gives CMS Authority To ‘Fix’ Medicare Provider Reimbursement Rates
As part of a larger bill (HR 5063) that would extend unemployment benefits to workers displaced by the economic recession, the House yesterday approved a provision that would give the Bush administration the authority to "fix problems" with the Medicare reimbursement formula for doctors, the AP/Los Angeles Times reports. The current Medicare formula cut payments to physicians by 5.4% this year and is scheduled to reduce payments by another 12% over the next three years, a loss of $11 billion in funds (AP/Los Angeles Times, 11/15). In May, CMS Administrator Tom Scully said that the agency does not have the power to alter the reimbursement formula to reverse the scheduled cuts (California Healthline, 5/17). Legislation that would have increased payments to Medicare providers was "bogged down" over a dispute between the Bush administration and Congress, which wanted to include additional funding for HMOs, hospitals and other providers, priorities the administration does not support (AP/Los Angeles Times, 11/15).
In June, the House passed a $30 billion Medicare reform bill that included provider giveback provisions and a prescription drug benefit, but the Senate has failed several times to pass similar legislation. During the current lame-duck session, health care lobbyists have failed to convince lawmakers to attach the Medicare provider giveback and prescription drug benefit bills to a continuing resolution that would fund government operations through Jan. 11, 2003 (California Healthline, 11/14). The provision the House approved yesterday does not offer providers any new money. The Senate approved a similar version of the overall unemployment bill yesterday, but it does not include the Medicare language (AP/Los Angeles Times, 11/15). The House and Senate have not yet reached any deal on the Medicare language because key senators reportedly do not want to address the physician fees without working on payments for other Medicare providers, CongressDaily reports (Rovner, CongressDaily, 11/14). "If the House thinks that they can dictate outcomes like this, that's a very dangerous strategy to adopt on the way out of town," a Republican leadership aide said (CQ Daily Monitor Midday Update, 11/14).
In other news, House Democrats yesterday elected Minority Whip Rep. Nancy Pelosi (D-Calif.) as minority leader, making her the first woman to head a party in either chamber of Congress, the Los Angles Times. Pelosi has served 15 years in Congress and won with 86% of the Democratic caucus vote, 177-29 (Anderson, Los Angeles Times, 11/15). Pelosi represents San Francisco in Congress, and her "signature issues" -- funding for AIDS research, women's health and human rights -- reflect the concerns of her district (Chaddock/Sappenfield, Christian Science Monitor, 11/15). During her campaign for minority leader, Pelosi said she would "reach out" to the moderate and conservative factions of the Democratic Party (Shepard, Cox/Atlanta Journal-Constitution, 11/15). Pelosi said she will present "clear alternatives" to Republican positions (Pelosi release, 11/14).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.