Senate Floor Action on $41 Billion Medicare ‘Giveback’ Bill May Not Come This Week
The Senate has no immediate plans to address the Finance Committee's $41 billion Medicare package, CongressDaily/AM reports. The committee was expected to introduce the package Monday night, but a spokesperson for Senate Majority Leader Tom Daschle (D-S.D.) said the Senate's agenda this week is "dominated" by other issues, including a resolution authorizing military action against Iraq (Fulton, CongressDaily/AM, 10/1). Aides did say, however, that the package could be added to the Senate's schedule this week, CongressDaily reports (CongressDaily, 9/30). According to an outline, the $41 billion, 10-year "giveback" package includes "smaller-than-planned" cuts for hospitals and increases in payments for rural physicians, hospitals and home health agencies. Medicare+Choice plans reportedly would receive a boost in payments of 4% in 2003 and 3% in 2004. The bill also would reverse the expiration of $1.7 billion in temporary Medicare funding for nursing homes (California Healthline, 9/27). The temporary funding is set to expire today (Washington, Washington Times, 10/1). The package also would expand a pilot program that uses competitive bidding for durable medical equipment nationwide. The plan also is expected to include a provision that would allow Medicare to cover immunosuppressive drugs for organ transplants and would renew a five-year program that helps low-income seniors pay their Medicare premiums. The plan also includes a two-year delay of payment caps for physical and occupational therapy and would expand coverage of cholesterol and lipid level tests. The package also includes additional funding for state Medicaid and CHIP programs (California Healthline, 9/27).
The Finance Committee is not expected to mark up the bill, and aides said the package could face a "rocky floor fight" from senators attempting to add in a prescription drug benefit. The package also faces objections from CMS Administrator Tom Scully, who said in a letter to committee members, "Many of the well-intentioned provisions of the bill will codify administrative initiatives that CMS has already undertaken, thereby reducing future management flexibilities and constraining our ability to manage taxpayer dollars efficiently." Scully instead urged the committee to draft legislation that focuses on "benefits and contractor reform," CongressDaily/AM reports (CongressDaily/AM, 10/1).
In other Medicare news, the House Ways and Means Committee on Friday sent a letter to HHS Secretary Tommy Thompson and Scully expressing concern about an administration proposal for a coverage appeals process for beneficiaries (House Ways and Means Committee release, 9/30). Congress in December 2000 passed a law that required CMS to create an appeals process for blanket coverage decisions, mandating that the process be in place by October 2001. Three beneficiaries and three advocacy groups sued CMS over its failure thus far to implement the appeals process (California Healthline, 8/7). Under a proposed process, beneficiaries would be permitted to appeal coverage decisions, but the outcome of the appeal would be applied only to that beneficiary and not all Medicare beneficiaries. In the letter, committee members said the administration's proposed rule "directly contravenes clear congressional intent" to create an appeals process that would "create policy for others" in the event of a successful appeal by an individual beneficiary. The letter asks Thompson and Scully to "reflect both the letter and spirit of the law" when revising the proposed regulation (Ways and Means letter text, 9/27).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.