Sens. Baucus, Grassley Introduce Medicare Provider ‘Giveback’ Package

Senate Finance Committee Chair Max Baucus (D-Mont.) and ranking member Charles Grassley (R-Iowa) yesterday formally introduced a $43 billion Medicare provider "giveback" bill under a Senate rule that allows the bill to bypass the committee and move directly to the floor, CongressDaily/AM reports (Rovner, CongressDaily/AM, 10/2). According to an outline, the 10-year 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 that expired yesterday. In addition, the package would expand a pilot program that uses competitive bidding for durable medical equipment nationwide. The plan also includes 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, 10/1).

In a statement, Baucus and Grassley said they decided to move the bill to the floor without committee approval because "the Senate is tied up in knots right now, and Medicare fairness is too urgent to fall victim to gridlock." However, CongressDaily/AM reports that Baucus and Grassley would not have been able to move the bill through the committee because committee members Sens. John Breaux (D-La.) and Olympia Snowe (R-Maine) said they would not approve a giveback bill unless it included a prescription drug benefit. The prescription drug benefit issue still could become a problem on the floor, CongressDaily/AM reports. Baucus, however, said he would "not support reviving a drug debate that threatens passage" of the giveback package. It is not clear when the Senate will act on the measure. For their part, House leaders are discussing their options if the Senate passes a Medicare giveback package without a prescription drug benefit. In June, the House passed a Medicare prescription drug benefit as part of a Medicare reform package that also includes $30 billion in provider reimbursement increases. Previously, "key lawmakers" said the House would not consider a Medicare bill without a drug benefit, but now House leaders are considering "various acceptable permutations" of a package because there is so little time remaining in the congressional session, CongressDaily/AM reports (CongressDaily/AM, 10/2).