Lawmakers Question Thompson About Budget’s Lack of Funding to Increase Medicare Provider Payments
"[S]keptical" members of the House Ways and Means Committee expressed concerns to HHS Secretary Tommy Thompson at a hearing yesterday about the lack of funding in President Bush's fiscal year 2003 budget to increase payments to Medicare providers, CongressDaily/AM reports. Lawmakers in both parties want to address the 5.4% provider reimbursement reduction that took effect Jan. 1, as well as recommended increases for some hospitals and scheduled reimbursement cuts for nursing homes and home health care agencies. Thompson said, "All the provider-payment issues should be on the table. There nee[d] to be some changes." But provider groups are unhappy that Bush's budget proposal calls for any increases in one area of Medicare to be offset by savings in another. In addition, Democrats expressed concern that the budget proposal's only increase to payers or providers would boost reimbursements to Medicare+Choice plans. Rep. Gerald Kleczka (D-Wis.) said that the General Accounting Office "has indicated point-blank that the Medicare+Choice program is costing the government more than fee-for-service [Medicare]. It's time that instead of dumping another $4 billion into the program, we admit it's a failure." Democrats also criticized Bush's $190 billion Medicare reform proposal, saying it does not allocate enough money to create a meaningful prescription drug benefit. "Seniors aren't going to be flimflammed into thinking they're going to get a benefit when what they're really getting is a pat on the head," committee ranking member Pete Stark (D-Calif.) said (Rovner, CongressDaily/AM, 2/7).
Speaking to reporters after the hearing, Thompson said that he favors making some popular prescription allergy drugs available over the counter, adding that the government will decide "very soon" whether to allow a switch, the Wall Street Journal reports. However, an HHS spokesperson later said that Thompson's comments "reflected his personal opinion and do not mean that a switch is necessarily going to occur." In response to a petition from the California-based managed care company WellPoint Health Networks, an FDA advisory panel said last spring that Schering-Plough's Claritin, Pfizer's Allegra and Aventis' Zyrtec are safe and should be sold over the counter. A spokesperson for the FDA, which has no deadline for making the decision, said the agency was still reviewing WellPoint's petition. An approval would mark the first time the FDA has switched a drug to over-the-counter status at the request of an insurer rather than the drug's maker. WellPoint estimates it would save $90 million a year if the switch was approved, while Schering-Plough, Pfizer and Aventis -- which have argued that the FDA does not have the authority to force a switch -- would face "massive drops" in revenue because over-the-counter drugs cost less than prescription drugs (Lueck, Wall Street Journal, 2/7).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.