Lawmakers Mull Options for Averting Scheduled Medicare Payment Cuts
Medicare physician reimbursement cuts are scheduled to take effect today, but Senate Democrats believe they might be able to avert the planned 21% payment reductions if they pass legislation in the next two weeks, CQ HealthBeat reports.
On Friday, A CMS spokesperson said Medicare can hold claims it receives for 10 working days but that the cuts would take effect after that point.
Congress could enact legislation after March 10 blocking the cuts retroactively to March 1, but physicians would need to file new claims to recoup the money lost from the lower reimbursements.
On Friday, Senate Finance Committee Chair Max Baucus (D-Mont.) said lawmakers would "have to move fairly quickly next week," to pass legislation blocking the cuts.
Proposed "Extenders" Bill
Senate Majority Leader Harry Reid (D-Nev.) tried to gain approval for an "extenders" bill (HR 4691) last week, but Sen. Jim Bunning (R-Ky.) objected to the measure and blocked its passage under unanimous consent.
The bill would have blocked the cuts until March 28, averted cuts in Medicare payments for outpatient rehabilitation services and extended a 65% subsidy for COBRA benefits for unemployed U.S. residents. The House approved the measure Thursday by a voice vote.
Bunning's objection stems from Democrats' classification of the bill as emergency spending, meaning Congress would not need to offset its cost (Reichard, CQ HealthBeat, 2/26). "If we can't find $10 billion somewhere for a bill that everybody in this body supports, we will never pay for anything," Bunning said (Vadala, CQ Today, 2/26).
Bunning also said Friday that he would sustain his objection, meaning Democrats would need to initiate the cloture process to pass the legislation (CQ HealthBeat, 2/26). Senate Republican leadership does not support Bunning's efforts to block the legislation (CQ Today, 2/26).
Democrats Consider Legislation With Longer Extensions
The extension legislation considered Friday would avert the cuts until March 28, but Democrats are considering longer term extensions as well.
A Reid spokesperson said, "We are moving to a package on longer-term extensions including unemployment insurance on Monday and will work on that through the week next week," adding that she could not comment on the length of the extensions because the "bill is still being finalized."
Baucus said he would meet with Reid on Monday to discuss the length of the extension.
Julius Hobson, a senior adviser at the lobbying firm Bryan Cave, said two-week, four-week and seven-month extensions have all been discussed (CQ HealthBeat, 2/26).
The Senate might consider the longer-term extension plans all this week and perhaps next week. As a result, some unemployment programs could be left unfunded for several days (Brady, Roll Call, 2/26).
Legislation Would Extend COBRA Subsidies
In addition to averting Medicare reimbursement cuts to physicians, the bill approved by the House last week extends COBRA subsidies for unemployed workers through March 2010 (Faler, Bloomberg News/Philadelphia Inquirer, 2/26).
COBRA allows workers who are laid off to retain their employer-provided health insurance for up to 18 months if they pay the full premium, plus an administrative fee. As part of the economic stimulus package, workers laid off between Sept. 1, 2008, and Dec. 31, 2009, were eligible for a subsidy to go toward maintaining their employer-sponsored health insurance (California Healthline, 12/22/09).
The 65% federal subsidy -- which is available to families for up to 15 months -- drives the cost of insurance for an average family down to $398 per month, whereas the family would pay $1,137 without the subsidy. Extending the subsidies will cost $6.8 billion in 2010, according to the Congressional Budget Office (Bloomberg News/Philadelphia Inquirer, 2/26).
AMA, CMA Criticize Payment Cuts
On Friday, the American Medical Association criticized lawmakers for not implementing a permanent overhaul to the physician reimbursement formula, resulting in the need for the bill to stave off the cuts on a temporary basis.
AMA President James Rohack said, "The Senate had more than a year to repeal the formula and ensure the security and stability of Medicare, but that opportunity has been squandered." Â He added, "This drastic cut will hurt our senior, disabled and military patients, as well as baby boomers who start entering the Medicare program next year" (CQ HealthBeat, 2/26).
Also on Friday, the California Medical Association called the Medicare payment cuts "unconscionable," adding that they would restrict seniors' access to health care and compel physicians to drop out of the program.CMA is urging its members to contact Sens. Barbara Boxer (D-Calif.) and Dianne Feinstein (D-Calif.) about the issue (Rauber, San Francisco Business Times, 2/26). 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.