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Lawmakers Complete Action on a Physician Rate Extension

By Paul Jenks

April 16, 2010 -- After a week of debate, an extension bill clears both chambers and is signed by the president while lawmakers begin to dig into the details of the new health care overhaul law.

Weekly Review
The Senate spent the entire week haggling over a delayed program extension bill (HR 4851) that only extended programs into next month. Included in the bill, but overshadowed by the more visible unemployment compensation extension provisions, is an extension of a reprieve from Medicare physician payment decreases. CQ HealthBeat reported that physicians were growing anxious by Thursday as the decreases technically began on April 1 and the original measure extended the period only until April 30. A Senate substitute amendment adjusted the extension to May 31. Senators adopted the revised measure on Thursday evening and the House quickly approved the bill two hours later. The president signed the measure before midnight.

The debate on the bill replicated some of the same Republican spending objections to an earlier extension bill (HR 4691) in March. A different longer-term extension bill (HR 4213) approved by both chambers but in different forms awaits a bicameral conference or leadership agreement on a final version. The cost of extending relief from the physician rate scheme for one month is pegged at over $2 billion.

The start of implementation of provisions of the health care overhaul law (PL 111-148) began in earnest this week. CQ HealthBeat reported Monday that the Department of Health and Human Services and other agencies released early rulemaking requests for comments on monitoring health insurance premium rate increases and insurance company reporting on medical loss ratios. HealthBeat reported Wednesday on new legislation that would extend older children's coverage provisions to veterans' health plans and CQ reported Monday that the Senate was able to quickly pass a measure that assured the inclusion of current military health plans (HR 4887). HealthBeat reported Thursday that Supreme Court Justice Stephen G. Breyer said he expects the health care overhaul law will be tested in the high court.

Also, CBO Director Douglas Elmendorf in a presentation this week revisited the CBO budgetary analysis of the health law and a CRS memorandum from last week detailed uncertainties about congressional health coverage provisions for lawmakers and staff. Additionally, House Energy and Commerce Chairman Henry A. Waxman, D-Calif., canceled a planned hearing next week on corporate write-offs caused by the health care overhaul law and released a preliminary report on corporate financial reporting on changes to retiree prescription drug benefits.

Coming up on lawmakers' agenda is the fiscal 2011 budget resolution. Early this week CQ reported on uncertainty that a budget blueprint will be crafted this year but another report on Wednesday noted that the Senate would start action on its resolution before the end of May. The resolution sets the funding levels for the regular appropriations bills and may include instructions for new reconciliation legislation, which was a critical tool that allowed the health care overhaul program to pass both the House and Senate last month.

Congressional committees met on several health issues this week. HealthBeat reported on a House Energy and Commerce session on smokeless tobacco use in baseball, and other sessions were held on children's nutrition programs, specialized defense health facilities and appropriations for the Indian Health Service.

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