Scully Tell Lawmakers Medicare Rx Drug Benefit, Not Givebacks, Should be ‘Top Priority’

CMS Administrator Tom Scully yesterday reinforced the Bush administration's stance that drug coverage for seniors is the "top health priority" and told Congress "not to go too far" in legislation to increase Medicare reimbursements to providers, CongressDaily reports. However, he did not say the White House would oppose legislation that included "givebacks" but did not include a prescription drug benefit for Medicare beneficiaries. "The administration is going to push very hard to only do [provider] givebacks that are justifiable from a public policy point of view," Scully said at the annual Medicare/Medicaid conference of the American Association of Health Plans. Such givebacks include fixing a "glitch" in the Medicare physician payment formula that resulted in a 5.4% cut in doctors' reimbursements this year and increasing payment rates for Medicare HMOs, he said (Rovner, CongressDaily, 9/10). On Monday, AAHP released a survey finding that HMOs serving about 200,000 seniors will exit the Medicare+Choice program next year, in large part because of inadequate reimbursement rates from the federal government (California Healthline, 9/10). Scully said that the administration has created "contingency plans" in case Congress does not pass legislation increasing rates for Medicare managed care plans this year.

Meanwhile, Jonathan Blum, a staffer for the Senate Finance Committee, said some lawmakers are considering a giveback bill that would include "smaller beneficiary improvements," such as extending Medicare payments for oral cancer and self-injectable drugs and making the Medicare appeals process more efficient (CongressDaily, 9/10). In addition, several senators have begun working "behind the scenes" on legislation that would provide more than $30 billion to increase funding to Medicare providers (California Healthline, 9/10). House and Senate health staffers said they "remain confident" that legislators will pass a giveback bill before the end of the legislative session, CongressDaily reports (CongressDaily, 9/10).