House & Senate Pass Medicare Reform Bills, Rural Provisions Intact
Late Thursday night (6/27), both the U.S. House of Representatives and the U.S. Senate passed versions of Medicare reform legislation. The House narrowly passed H.R. 1, the "Medicare Prescription Drug and Modernization Act of 2003," by a vote of 216-215. This bill provides for Medicare physician updates of at least 1.5% in 2004 and 2005. H.R. 1 also included regulatory relief requirements that the AMA and MMA have advocated to address physician concerns regarding Medicare carrier audits and payment increases for physicians in rural and underserved areas.
The Senate also overwhelmingly passed its version of Medicare reform legislation (S.1) by a margin of 76-21. Both Olympia Snowe and Susan Collins voted for the bill. "Sense of the Senate" resolutions were offered regarding the physician payment formula and were included in S.1 as passed. These resolutions, which passed by voice vote, urge Congress to fix the payment formula to prevent additional cuts in physician payments.
While the primary purpose of both bills was to provide prescription drug coverage to Medicare recipients, beginning in 2005, the bills contain several provisions of vital interest to physicians. Now that both bills have passed, a conference committee must meet to work out differences in the two bills before a final bill can be enacted and passed on to the President for his signature. Senators Snowe and Collins supported the Senate bill; Congressmen Allen and Michaud opposed the House Bill.
Conference committee work will begin when Congress returns from the Fourth of July recess on July 7. Efforts will be made to complete a conference agreement before the August recess which begins on August 4th and extends until Sept. 3rd. The top priority issues for physicians in the conference are:
* A two-year payment formula fix, resulting in positive updates in 2004 and 2005, rather than the 4.1% reduction in payments that will otherwise take place.
* geographic payment adjustments which will result in Maine physicians being paid better in relationship to others around the country
* Defeating inclusion in the bill of the creation and use of an ICD 10 set of codes.
* Regulatory relief.
* Eliminating electronic prescribing requirements.
* Adequate financing of both traditional Medicare and private plan options.
Maine Senator Olympia Snowe was successful in obtaining Senate support to restore $2.7 billion to the State Children's Health Insurance Program which will bring an estimated $13 million to the State of Maine through the program that extended Medicaid to more low-income children.
Bot the Senate bill and the House bill contain provisions enhancing reimbursement to rural physicians by establishing a floor for the work geographic practice cost index for 2004 and 2005.