|
In this issue, you'll find:
Senate Votes to Proceed to Healthcare Reform Bill
House Passes Bill that Blocks 21 Percent Cut to Physician Fees
CMS Releases Data on Medicare Physician Quality Reporting Initiative
Grassley Introduces Bill to Fight Medicare Fraud
PPSV Attorney Co-Chairs Seminar on Worker's Compensation and SSDI
Hearings
Top Story
Senate Votes to Proceed to Healthcare Reform Bill
On Saturday, November 21, the Senate voted along party lines to proceed to debate on HR 3590, the Senate version of the healthcare reform bill. The chamber is scheduled to continue debate on the bill Monday, November 30. The Senate is expected to continue negotiations well into December, with many stakeholders questioning whether the final vote will come before the Christmas recess. The House has already passed their more expensive and generally more liberal bill to overhaul the healthcare system.
The Senate bill, the Patient Protection and Affordable Care Act, has a number of controversial provisions that moderates warn could prevent their support for cloture to end debate, which requires 60 favorable votes. Not least of those provisions is the public option, which Majority Leader Harry Reid (D-NV) supports in the form of an "opt out" option and which a few moderate Democrats oppose. The moderates, which include Democratic Senators Ben Nelson (NE), Blanche Lincoln (AR) and Mary Landrieu (LA), will likely push for more changes to the final bill in exchange for their support of a final package.
The public plan in the current Senate bill requires a Community Health Insurance Option to be offered through Exchanges, unless a state chooses to opt out of the public plan. Premium rates would be geographically adjusted to cover expected costs. The legislation would have the HHS Secretary negotiate provider reimbursement rates and would authorize the Secretary to contract with nonprofits for the administration of the option.
Health Care News
House Passes Bill that Blocks 21 Percent Cut to Physician Fees
The House of Representatives last week passed the Medicare Physician Payment Reform Act of 2009 (H.R.3961), which would block a pending 21 percent cut to Medicare physician payments in 2010 and restructure the sustainable growth rate formula. 11 Democrats and 172 Republicans voted against the legislation, which opponents view as too costly. The Congressional Budget Office has scored the bill at $210 billion over the next decade, and that cost is not offset in the bill.
To help gain support for the bill, House Democratic leaders added a statutory pay-go to the legislation. The House rejected a Republican measure, which included a four-year doc fix and which included offsets. The Senate failed to move to debate on a similar bill last month.
CMS Releases Data on Medicare Physician Quality Reporting Initiative
CMS earlier this month released information on incentive payments to physicians who successfully reported quality data. The number of professionals earning an incentive payment under the Physician Quality Reporting Initiative (PQRI) increased by one-third between 2007 and 2008, according to the CMS data. More than 162,800 professionals participated and just over half met the requirements for satisfactory reporting. CMS has also identified about 4,000 additional eligible professionals to receive 2007 PQRI incentive payments.
Grassley Introduces Bill to Fight Medicare Fraud
Last Wednesday, Senator Charles Grassley (R-IA) introduced the Fighting Medicare Payment Fraud Act of 2009, which would authorize the HHS Secretary to extend the time for payment of claims in a case of suspected fraud. S.2774 would have the Office of Inspector General annually recommend categories of providers or suppliers in which additional scrutiny is needed before claims are paid. Grassley has said that slowing the payment process so that more reviews could take place would help prevent Medicare fraud.
PPSV in the News
PPSV Attorney Co-Chairs Seminar on Worker's Compensation and SSDI
On Wednesday, November 18, PPSV principal Bobby Silverstein co-chaired a policy research seminar on the implications of workers' compensation for SSDI. The seminar was meant to promote dialogue and understanding among experts in the nation’s two largest disability income maintenance programs: Social Security disability insurance and workers’ compensation. Besides co-chairing the all day seminar, Silverstein offered concluding observations.
Upcoming Events
Hearings
No healthcare hearings have yet to be scheduled for this week.
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.
Powers Pyles Sutter & Verville P.C. is a full service law firm specializing in health care and education law and located at 1501 M St., NW 7th Floor, Washington DC 20005
© Copyright 2009, Powers Pyles Sutter & Verville P.C.
All rights reserved.
Terms & Conditions | 
