Medicare Reimbursements Focus of Budget Negotiations
Budget negotiators early on Tuesday "appeared close to agreement" on a 1% increase in Medicare reimbursement for physicians under a fiscal year 2006 deficit reduction package, but lawmakers did not appear to agree on the cost of the measure, about $18 million, CongressDaily reports.
House Energy and Commerce Committee Chair Joe Barton (R-Texas) later on Tuesday "hinted talks had broken down," according to CongressDaily. Barton said, "If the bill came up tomorrow, (physicians) would get a 4.4% cut" in Medicare reimbursements, as is currently scheduled (Cohn, CongressDaily, 12/14).
Reimbursement rates were the "key issue" on Tuesday in a meeting of Barton, Senate Finance Committee Chair Chuck Grassley (R-Iowa) and House Ways and Means Committee Chair Bill Thomas (R-Calif.), CQ HealthBeat reports. The cost of delaying the scheduled reimbursement cut for two years might be offset by spending reductions for other health care sectors, CQ HealthBeat reports (Reichard, CQ HealthBeat, 12/13).
Grassley said decisions also had not been reached on the final size of Medicaid cuts and the possible elimination of a "stabilization fund" created under the 2003 Medicare law for regional private prescription drug plans.
The committee chairs predicted a deal by Wednesday or Thursday (Reichard, CQ HealthBeat, 12/13).
The American Medical Association on Tuesday in a letter urged congressional leaders to increase physician reimbursements and to abandon "pay-for-performance" measures under consideration, CQ HealthBeat reports (Carey, CQ HealthBeat, 12/13). Congress is considering a pay-for-performance proposal that in 2007 would cut 2% of Medicare reimbursements if a physician did not report quality data to the federal government (Higgins, Washington Times, 12/14).
AMA Executive Vice President and CEO Michael Maves in the letter listed a number of steps AMA has taken to determine physicians' quality of care. Maves wrote, "At this time, the AMA believes that Congress needs the benefit of analysis and experience gained from recently initiated (CMS) pay-for-performance demonstration projects and a voluntary physician reporting program before legislation is adopted."
Maves added that AMA in 2006 will work with CMS to agree on a number of evidence-based quality measures, which would be used for a voluntary reporting program to be implemented in 2007 (Carey, CQ HealthBeat, 12/13).
Summaries of editorials responding to the budget proposals appear below.
- Hampton Roads Daily Press: A House proposal to increase the maximum allowable copayments for Medicaid beneficiaries is the focus of a "tricky debate, often simplified by proponents on all sides," a Hampton Roads Daily Press editorial states. The editorial adds that the debate "is worth watching closely, because national efforts to trim back Medicaid will be mirrored at the state level" (Hampton Roads Daily Press, 12/13).
- Washington Post: "Though neither [the Senate nor House deficit reduction package] offers much to cheer about, the Senate's version is by far the fairer," a Post editorial states. For example, the Senate would save $8.2 billion over five years by increasing the rebates drug companies pay to Medicaid, compared with House savings of $2.2 billion over five years. In addition, the Senate proposal would eliminate the $10 billion fund in the 2003 Medicare law that aims to encourage insurers' participation in the drug benefit. The House bill would not cut the fund. The editorial says, "It's a choice between cutting the profits of pharmaceutical companies and eliminating a slush fund for insurers, on the one hand, and demanding higher copayments and premiums from low-income Medicaid recipients on the other: not a tough call" (Washington Post, 12/14).