Wednesday, July 09, 2008

Senate approves Medicare fix

Sen. Ted Kennedy (D Mass) returned briefly to the Senate floor tonight to vote in favor of ending Senate debate over the House version of the Medicare fix bill. The Senate voted in favor cloture and the House bill by a veto proof 69-30 margin.

The Medicare fix bill will avoid the 10.6% cut in Medicare reimbursement to doctors that was scheduled to take effect on July 1 and an additional 5% cut proposed for 2009. Instead doctors will receive a 1.1% bump in 2009. The Wall Street Journal notes that "But perhaps the bill's most significant long-term effect: initially increasing Medicare payments to physicians who make the switch from hand-written prescriptions to digital ones, then docking doctors' fees in later years if they fail to adopt the technology." The newly merged SureScripts-RxHub applauded the change.

As this fix occurred within the freeze period administratively set by CMS, presumably there will be no Medicare secondary claims that require re-processing by FEHB plans.

The funding for the fix will come from cuts to the Medicare Advantage program. According to the AP,

The Congressional Budget Office projected that insurers would get about $13.5 billion less in Medicare payments over the next five years.

Citigroup analyst Paul Heldman expects Humana, Aetna Inc. and Coventry Health Care Inc. to be hardest bit by the changes. All three companies have a large number of patients enrolled in Medicare Advantage plans targeted by the legislation. The payment reductions are not expected to take effect before 2010.

The Medicare fix bill also delays for 18 months a durable medical equipment competitive bidding initiative that the Centers for Medicare and Medicaid Services ("CMS") currently have underway. HHS Secretary Mike Leavitt warned in a Wall Street Jounal op ed today "Make no mistake: "Delay" means "kill." Killing this competitive-bidding program would cost taxpayers about $1 billion annually, while unjustly overcharging senior citizens."

On a related note, the New York Times reports today that

Congressional investigators said Tuesday that Medicare had paid tens of millions of dollars to suppliers improperly using identification numbers of doctors who died years ago.

The government has no reliable way to spot claims linked to dead doctors, many of whom are still listed as active Medicare providers though they died 10 or 15 years ago, the Senate Permanent Subcommittee on Investigations said.

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