Legislative Updates

From Jean Jones
DVR/DVS Legislative Information Representative

2009 ~ 2008 ~ 2007

July 16, 2008
Congress Enacts Medicare Improvements Act Over President's Veto

On July 15th, the U.S. House and Senate both overrode President Bush's earlier veto of H.R. 6331, the Medicare Improvements for Patients and Physicians Act of 2008.

The bill postpones scheduled cuts in Medicare physician payments to physicians and hospitals. According to many, the legislation was needed to preserve access to health care for millions of Americans on Medicare.

The House voted 383-41 to override the President's veto, while the Senate passed the bill by 70-26.

Specifically, H.R. 6331 would prevent a 10.6 percent reduction in the Medicare payment rate for physician services (set to take effect on July 1, 2008) and provide physicians with a 1.1 percent increase for 2009. In order to offset this action on physician fees, the bill reduces reimbursements to Medicare Advantage plans, HMO-type plans often operated by private insurance companies, which the bill's supporters say have been getting overpaid at a rate of 13 percent or more.

Other provisions in the bill include:

• an 18-month postponement of the Medicare DME competitive bidding initiative (offset by a small reduction in DME rates to vendors, reportedly acceptable to DME vendors if the competitive bidding plan is scuttled)
• Expansion of preventative services under Medicare
• Reauthorization of diabetes programs including one serving Native Americans
• Incentives for doctors to use e-prescribe technology
• Anti-fraud provisions
• Restoration of certain funding for veterans health care
• Provisions to protect patient access to community pharmacies
• Phases-in of a reduction in co-payments for mental health benefits to reach parity with cost-sharing for other Medicare benefits

Expansion of funding for a Medicare medical home demonstration project that will study the impact on quality and cost of a new program to reimburse primary care physicians for care coordination. This concept has also been promoted in legislation considered by the Oklahoma Legislature this year.

With H.R. 6331 now law, Congress can redirect its attention from just 'stopping the cut' to enacting comprehensive and long-term reforms of Medicare payment and coverage policies. In the medical field, the enactment of this legislation is also being heralded as a critical step to strengthen the foundation for quality health care in America by enhancing the ability to recruit and retain talented doctors for primary and diagnostic care.

H.R. 6331 had earlier received strong bipartisan support in the House, and to a lesser degree in the Senate, which took two tries to pass the bill. Virtually all aging and disability organizations had signaled their support for the bill and most health care industry groups had lobbied for its passage.