Senate Committee Has Begun To Draft Bill To Prevent Reduction In Medicare Physician Payments

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Primary Care / General Practice
Article Date: 28 Sep 2007 - 6:00 PDT

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The Senate Finance Committee has begun to draft a bill that would eliminate a 10% reduction in Medicare reimbursements to physicians scheduled to take effect on Jan. 1, 2008, according to Democratic committee aide Shawn Bishop, CQ Today reports. The legislation would finance the elimination of the reduction through a decrease in reimbursements to Medicare Advantage plans. He said that the committee has not made a decision about the amount of the decrease, adding, "This is not a slash and burn exercise here on Medicare Advantage."

The bill also could include provisions to extend extra Medicare reimbursements to rural health care providers, which will expire at the end of the year; to ensure that community pharmacies receive prompt payments for medications dispensed under the prescription drug benefit; and to reduce eligibility requirements for low-income subsidies provided under the program. In addition, the legislation could include provisions to eliminate copayments for Medicare beneficiaries for preventive services, to provide incentives for physicians to provide such services, and to establish a framework for "government comparative effectiveness" research to ensure that the program uses the most cost-effective treatments.

Health care lobbyists have estimated the cost of the bill at $20 billion (Armstrong, CQ Today, 9/25).

Anemia Rx Reimbursements
House Ways and Means Subcommittee on Health Chair Pete Stark (D-Calif.) on Tuesday released a letter from the HHS Office of the Inspector General that said Medicare could save $187 million annually through a reduction in reimbursements for the anemia medication Epogen to the level paid by the Department of Veterans Affairs, CQ HealthBeat reports. According to Stark, HHS OIG "found that Medicare pays $9.10 per 1,000 units of Epogen, while the VA pays only $8.03" for the same amount.

In the letter, dated Aug. 17, HHS Inspector General Daniel Levinson wrote, "It is important to note that in comparison to Medicare, VA has a much smaller number of beneficiaries who require ESRD (end-state renal disease program services, which are those provided by Medicare to dialysis patients) and that VA purchases drugs directly from manufacturers or wholesalers while Medicare reimburses facilities for drugs administered to beneficiaries."

Stark said, "These overpayments endanger patients' health and enrich a wealthy corporation ... at taxpayers' expense" (Reichard, CQ HealthBeat, 9/25).

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