Oh, the inscrutable Medicaid program. Governors look at it, and don't understand. The public hears passing mention of it in the news, and gets the wrong idea. Rugged individualists think they can bring it to heel, and it jumps up and bites them. Politicians think they can ignore it, but find it bleeds profusely when cut. As congressional debate over the program's future heats up, politicians, the public, the press and even policy wonks and providers are all getting a crash course in the mysteries of Medicaid and its unsuspected role undergirding the entire U.S. health care system. Read more »
A mechanism within the 2003 Medicare overhaul law that aims to ease the cost burden on states for providing drug coverage to people enrolled simultaneously in Medicare and Medicaid follows a flawed formula that undermines its purpose, according to the National Governors Association. Under the "clawback" mechanism, Medicare picks up the costs of drug coverage for those "dually eligible" for both Medicare and Medicaid, but states repay 90 percent of those costs next year through clawback payments. Read more »
A Congressional Budget Office analysis of President Bush's fiscal 2006 budget plan finds the administration's Medicaid overhaul proposal would save $27 billion over the next decade, a figure well below administration projections. The CBO document also states federal spending on Medicare will be $70 billion more than CBO estimated in January for the 2006-2015 period. The higher figure is due primarily to revised estimates of the cost of the new Medicare prescription drug program. Read more »
Hundreds of physicians assembled in Washington wanted to hear Bush administration officials and Capitol Hill lawmakers promise to fix scheduled cuts in Medicare payments to physicians and overhaul the nation's medical malpractice system. That's exactly what they got at the Mayflower Hotel, but there was bitter with the sweet. Read more »
A physicians group warned lawmakers to move cautiously on proposals to link Medicare payment for doctors' services to their performance on measures of quality of care, saying that many physicians are not ready for such a change. The Alliance of Specialty Medicine, a coalition of 13 medical groups representing more than 200,000 specialty physicians, also urged Congress to take steps this year to avert scheduled annual payment cuts of approximately 5 percent between 2006 and 2013. Read more »
Senate Majority Leader Bill Frist said that the government can encourage the health care industry to invest in information technology by keeping a focus on electronic information-sharing standards. Using government resources to promote "interoperability" would do more than distributing federal grants to hospitals, physicians, and other health care providers to install health care IT systems, Frist, R-Tenn., said after a speech to America's Health Insurance Plans, a trade group representing health care insurers. Read more »
Spirits are up at HHS following reports that two of the nation's biggest health insurers are likely to square off next year in a Medicare drug benefits marketplace some analysts predicted would never materialize. Both UnitedHealth Group and Aetna said they intend to offer drug coverage nationally. HHS Secretary Michael O. Leavitt now predicts perhaps "the most competitive market we've ever seen in prescription drugs." Read more »
The House Education and Workforce Committee approved a bill that would help small businesses purchase health insurance after narrowly staving off adoption of an amendment aimed at making it more difficult for insurers or companies to discriminate against higher-risk patients. The panel voted along party lines to adopt the bill, which would allow small businesses that band together into association health plans to bypass state laws that mandate coverage for specific treatments and procedures. Read more »
That March 1 ritual in the health policy world, the submission by the Medicare Payment Advisory Commission of its annual recommendations to Congress, has in some respects become empty. Reporters wring it dry of news long before by filing stories on the recommendations for payment updates adopted by the commission at its January meeting leading up to the report. But missing in the nitty gritty details of those recommendations this year is a larger theme, that Medicare may soon begin moving toward a system of differential payment. Read more »
New York Gov. George Pataki introduced a plan to "right-size" his state's health care system that includes many of the innovations the Bush administration hopes to foster with its proposal to give states greater control over Medicaid. With HHS Secretary Michael O. Leavitt by his side, Pataki discussed his plan to eliminate underused hospital and nursing home beds, spend $1 billion on health care information technology, and rely more on home-based care rather than nursing home care. Read more »
The Medicaid spending reductions included in the House and Senate budget resolutions are likely to weaken health care coverage for low-income Americans and increase the ranks of the uninsured, according to two reports released by the Center on Budget and Policy Priorities. Both proposals would go farther than the Medicaid spending changes in the Bush administration's fiscal 2006 budget that have already drawn opposition from the nation's governors. Read more »
The Senate Health, Education, Labor and Pensions Committee approved legislation aimed at improving patient safety. The bill (S 544), approved by voice vote, would establish a legal framework for health care providers to report medical errors without fear of the data being used in malpractice lawsuits and would set up a database to track such errors to analyze trends and prevent repeating common mistakes. Read more »
In adopting its budget resolution, the Senate posed more questions than it answered for the budget conferees who will begin to hammer out a deal when lawmakers return to Capitol Hill in two weeks. The House by 218-214 adopted its resolution (H Con Res 95) calling for mandatory spending cuts of $69 billion and tax cuts totaling $106 billion, including $45 billion in tax cuts that would be protected from a filibuster in the Senate. Read more »
A panel of state Medicaid administrators appearing at a congressional forum said between the Medicare drug benefit and a Medicaid overhaul plan proposed by the Bush administration, states face higher costs associated with the publicly funded insurance for the poor. However, CMS Administrator Mark McClellan denied the Medicare drug benefit would add to state costs, saying it would save them billions of dollars. Read more »
Ways and Means Health Subcommittee Chairwoman Nancy L. Johnson, R-Conn., signaled at a House hearing how she aims to reform Medicare payments to physicians, while stressing that her thinking on the matter is still "embryonic." The key elements: Get rid of the "Sustainable Growth Rate" (SGR) system that has lined up physicians for big annual cuts over the next several years and replace it with a system that rewards doctors who perform well on specific measures of quality care. Read more »