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WASHINGTON WIRE

June 20, 2008
Issue 174

Congress Continues to Work toward a Medicare Bill
House Passes Compromise Supplemental Spending Bill
Senate Bill Introduced to Delay Medicare Competitive Bidding Program
Hearings

Top Story

Congress Continues to Work toward a Medicare Bill

Late this week, further action on passing a Medicare package picked up steam as cuts to various programs loom on July 1.

As the Senate Republican and Democrat leaders of the Finance Committee agreed to proceed in negotiating a Senate Medicare package, the House decided to use Senate bill S. 3101 as the basis for a House bill to be considered Tuesday morning under the House 'suspension calendar.' This allows for expedited consideration of legislation in turn for requiring a two-thirds majority to pass if a formal roll call vote is requested.

The central component of the new House bill proposal is an 18-month fix to projected physician payment cuts which prevents the 10.6 percent cut scheduled for July 1 and raises those payments for all of 2009 by 1.1 percent.

A key addition is the compromise delay in competitive bidding program for durable medical equipment under Medicare that was agreed to in both chambers late last week. Also, the cuts in Medicare payments in the original Senate bill for oxygen and power wheelchairs were removed.

Other provisions expand low-income Medicare beneficiary assistance, provide reimbursement incentives for physicians to adopt electronic prescribing systems, and require insurers to promptly pay pharmacies for Medicare-covered prescription drugs as well as provisions for dialysis providers, community health centers, ambulances, rural providers, psychologists, social workers and others.

The package would be paid for through a variety of sources including Medicare Advantage Indirect Medical Education (IME) cuts, a fund to improve the Medicare fee-for-service program, a levy on tax-delinquent providers, amongst others.

The Senate announcement came after a week of inaction since the original Senate (Baucus) bill failed to gain enough votes last week to invoke 'cloture' to close general debate and to move to the amendment process on the bill.

Considering previous Republican opposition to an expansion of low-income assistance or to fund the bill with cuts to Medicare Advantage insurers, it is unclear whether this bill will pass under the suspension calendar by voice vote or secure enough Republican support to meet the two-thirds roll call vote requirement. Regardless, a slimmer compromise package is under negotiation in the Senate and it is possible a final compromise could pass both chambers before the July 1 deadline. However, it is also possible final action may have to wait until after the Congressional recess the week of July 4th.

Health Care News

House Passes Compromise Supplemental Spending Bill

On Thursday, the House approved a $161.8 billion war supplemental spending bill, which included moratoria on 6 of 7 pending controversial Medicaid regulations. Although versions of the war supplemental had already passed both the House and Senate prior to yesterday, changes made by each chamber during floor consideration and ongoing negotiations with the White House forced the House, and soon the Senate, to vote again on the revised spending bill.

The legislation would delay regulatory changes to Medicaid coverage of targeted case management, rehabilitative services, intergovernmental transfers, provider taxes, graduated medical education, and school-based services. Negotiations forced Democrats to drop a moratorium on the Medicaid outpatient services regulation, which was included in previous versions of the bill.

The bill was brought to the House floor in two parts - the first amendment provided the war funding and was approved by a vote of 268-155. The second amendment consisted of the domestic spending (including the Medicaid regulation delays) and passed by a vote of 416-12.

The Senate is expected to vote on the revised legislation next week and the President is expected to sign it.

Senate Bill Introduced to Delay Medicare Competitive Bidding Program

On Tuesday, a bipartisan bill was introduced in the Senate to delay the implementation of the Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS).

The Medicare DMEPOS Competitive Acquisition Reform Act of 2008 (S.3144) was introduced by Senate Finance Committee Chairman Max Baucus (D-MT) and Ranking Member Charles Grassley (R-IA), along with more than 20 other Senators.

The bill mirrors the House bill (HR. 6252), introduced last week by Congressmen Stark (D-CA) and Camp (R-MI), and would, among other provisions, delay the scheduled July 1st implementation date of Round I of the program for 18 months.

The bill is expected to be passed as part of the pending Medicare physician payment legislation.

Upcoming Events

Hearings

Tuesday, June 24, 2008

Health Equity
House Energy and Commerce - Subcommittee on Health
10 a.m., 2322 Rayburn

Antimicrobial Resistance
Senate Health, Education, Labor and Pensions Committee
10:30 a.m., 430 Dirksen

Fiscal 2009 Appropriations: Labor, HHS and Education
Senate Appropriations - Subcommittee on Labor, Health and Human Services, Education, and Related Agencies
11 a.m., 138 Dirksen

Online Pharmacies and Internet Drug Abuse
House Judiciary - Subcommittee on Crime, Terrorism and Homeland Security
11:30 a.m., 2141 Rayburn

Thursday, June 26, 2008

Contract Health Services
Senate Indian Affairs Committee
9:30 a.m., 562 Dirksen

Fiscal 2009 Appropriations: Labor-HHS-Education
House Appropriations Committee
10 a.m., 2359 Rayburn

Fiscal 2009 Appropriations: Labor-HHS-Education
Senate Appropriations Committee
2 p.m., 106 Dirksen

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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