Washington Health Policy Week in Review
Medicare Bill May Be on Senate's Back Burner Awhile

By Mary Agnes Carey, CQ HealthBeat Associate Editor

May 2, 2008 -- Senate action on Medicare legislation is likely to slip until late May or early June due to current work on a bill that would place a moratorium on new Medicaid regulations and the Iraq war supplemental spending bill, an AARP official said today.

Kirsten Sloan, the group's lead health care lobbyist, outlined a number of priorities AARP hopes to include in the package, such as minimizing the financial impact of any Medicare physician pay increase on beneficiaries' Part B premiums and raising the amount of assets beneficiaries may have and still qualify for low-income premium assistance as part of the Medicare drug benefit. The current asset level, not including an individual's home, car, or $1,500 for burial services, is $11,990.

A spokesman for Senate Finance Committee Chairman Max Baucus, D-Mont., had no immediate comment Friday on the timing of Senate floor action on the Medicare bill. A Senate Democratic leadership aide said Friday that the delay in floor action was due to ongoing negotiations on the Medicare bill. "This isn't because of Medicaid or Iraq or anything else," the aide said. "And we don't know enough yet to be so specific to say May or June."

In a letter sent to Capitol Hill April 24, AARP Chief Executive Officer William D. Novelli urged lawmakers to include electronic prescribing in the Medicare bill, as well as establish a comparative effectiveness commission to evaluate treatments based on cost and quality and improve Medicare's coverage of preventive services. Starting Sunday, the group is also launching a television advertising campaign through mid-May to highlight AARP's goals for the Medicare package. AARP members are also contacting members' offices via e-mail, online petitions, and direct mail.

Baucus said last month that he intended to have Medicare legislation on the Senate floor in mid-May, and that payment reductions to Medicare Advantage (MA) plans were a possible financing mechanism. Baucus, along with the panel's ranking Republican, Charles E. Grassley of Iowa, and Senate leaders are now developing the Medicare package that would prevent a scheduled 10.6 percent cut in Medicare physician payments scheduled for July 1. Baucus has said he favors an 18-month fix for physicians.

Sloan said potential pay-fors in the Medicare package are reductions in a Medicare "stabilization" fund created by the 2003 Medicare drug law (PL 108-173) to entice preferred provider organizations to offer coverage in underserved regions. Others include reducing indirect medical education (IME) payments to MA plans, tapping into funding for a Medicare program that provides bonus payments for physicians who participate in a voluntary data reporting program, and reducing Medicare payments to other providers.

"This is the time this year" to address beneficiary issues in a Medicare package, Sloan said, adding the June 30 deadline for Medicare physician payment issue has created "more momentum than usual to get something done."


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