WASHINGTON WIRE
October 19, 2007
Issue 149
House Fails to Override SCHIP Veto
Finance Committee Begins Discussions on Medicare Package
Senator Baucus and Grassley Question CMS on Investor-Owned Nursing Homes
Top Story
House Fails to Override SCHIP Veto
On Thursday, House leaders fell 13 votes short of the two-thirds majority needed to override the President's recent veto on the children's health bill.
In early October, the House and Senate sent to the President a compromise bill to reauthorize the State Children's Health Insurance Program (SCHIP) and invest an additional $35 billion over five years. The President promptly vetoed the legislation stating that such an expansion represents a step toward government-run healthcare. The Senate had approved the SCHIP compromise bill with a veto-proof vote of 67-29, however, House leaders failed to garner such support.
The President has signaled that we would sign an SCHIP bill that goes beyond his proposed $5 billion expansion but only if the legislation targets what he considers to be "low-income" children. Emphasizing this sentiment, the Administration recently sent a letter to state health officials announcing new SCHIP policies that would require states serving children above 250% of the federal poverty level to meet several criteria in order to obtain federal approval to cover children above this threshold. Many stakeholders consider the criteria to be unrealistic.
After Thursday's vote in the House, Congressional leaders must now consider other SCHIP reauthorization options. House Speaker Nancy Pelosi (D-CA) stated that Congress would send another SCHIP bill to the President within two weeks. Congress has approved a short-term SCHIP reauthorization until November 16, 2007.
Health Care News
Finance Committee Begins Discussions on Medicare Package
Senate Finance Committee Members met earlier this week to begin discussions on a potential Medicare package with the primary driver being a Medicare physician payment adjustment.
Under the sustainable growth rate (SGR) formula currently used to calculate Medicare physician payments, doctors are schedule to receive a 10 percent reimbursement cut next year. It is very unlikely that Congress will allow such a cut to take effect and the House has already approved legislation to provide physicians with a 0.5 percent payment increase each year over the next two years. In addition, the House package proposes a long-term solution in later years that would replace the SGR system. It is unclear if the Senate will take the same approach on either provision.
In order to pay for any physician payment adjustment, the Senate will likely make cuts to other Medicare providers groups and potentially the Medicare Advantage (MA) program (Medicare managed care). The House paid for much of its doctor reimbursement fix through significant cuts to the MA program, however, several Members of the Finance Committee appear to be opposed to such just cuts.
Overall, stakeholders estimate a Medicare package could cost between $20 and $30 billion over five years, but do not expect to see a draft for at least a couple of weeks.
Senator Baucus and Grassley Question CMS on Investor-Owned Nursing Homes
In an October 16th letter to Kerry Weems, Acting Administrator of the Centers for Medicare and Medicaid Services (CMS), Senate Finance Committee Chairman Max Baucus (D-MT) and Ranking Member Charles Grassley (R-IA) stated their growing concern over the role of large investment companies in the nursing home industry.
The letter was prompted by a recent article in The New York Times that examined the quality of care provided by investor-owned nursing homes. The article targets a particular nursing home in Tampa Florida where, following its purchase by a large investment firm, conditions declined and, according to family members, 15 residents died in three years as a result of negligent care.
The Senators also stated their concerns with the lack of transparency regarding who is responsible for resident care and the operation of investor-owned nursing homes.
In a related press release, the Finance Committee leaders state that the vast majority of nursing home expenses are paid for by Medicaid and Medicare and CMS is responsible for overseeing state-level inspections of nursing homes and ensuring that federal standards for quality of care are met.
The Senators also requested a briefing from CMS on what information the agency has on nursing home purchases by large investor-owned companies and any actions CMS has taken or is planning to take to address quality and safety concerns at such facilities. A response was requested by November 2, 2007.
Upcoming Events
Hearings
Tuesday, October 23, 2007
Bioterrorism Response
Senate Homeland Security and Governmental Affairs Committee
10 a.m., 342 Dirksen
Environmental and Health Impact of Uranium Mining on Navajo Lands
House Oversight and Government Reform Committee
10 a.m., 2154 Rayburn
Veterans' Benefits Bills
House Veterans' Affairs - Subcommittee on Disability Assistance and Memorial Affairs
2 p.m., 334 Cannon
Wednesday, October 24, 2007
Veterans' Affairs Bills
Senate Veterans' Affairs Committee
9:30 a.m., 562 Dirksen
DoD and VA Sharing of Electronic Medical Records
House Veterans' Affairs - Subcommittee on Oversight and Investigations
10 a.m., 334 Cannon
Ocean Exploration, Health IT and Mine Communications
House Science and Technology Committee
10 a.m., 2318 Rayburn
Thursday, October 25, 2007
Small Business Health Insurance
Senate Finance Committee
10 a.m., 215 Dirksen
Home Health Care
House Education and Labor - Subcommittee on Workforce Protections
10 a.m., 2175 Rayburn
Impact of Health Insurance Consolidation on Small Business
House Small Business Committee
10 a.m., 2360 Rayburn
For More Information
For further information on any topics discussed or publications listed, or to get copies of anything mentioned in this alert, please call 202.466.6550 and ask for the Legislative Practice Group.
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