MINNEAPOLIS, June 18, 2008—Competing Senate bills to broach the Medicare reimbursement gap are making it increasingly unlikely that either will be passed in time to be helpful in alleviating the 10.6 percent payment reduction scheduled to take effect July 1.

The Democratic bill is S. 3101, introduced by Senators Max Baucus (D, Montana), Olympia Snowe (R, Maine), Jay Rockefeller (D, West Virginia), and Gordon Smith (R, Oregon).  An MMA Action Alert last week urged MMA members to call and urge Congress to support the Baucus bill.

S. 3101 takes steps to put the Medicare Advantage program on equal footing with traditional Medicare, therefore helping to preserve the Medicare fee-for-service program on which most seniors depend.

On Thursday, the Baucus bill failed to gather enough support in the Senate for a closure vote. On the other hand, Sen. Norm Coleman voted yes for it, which was a main goal of an MMA Action Alert sent out earlier in the week. Physicians may use this page to thank Sen. Coleman for his support.

Sen. Klobuchar voted yes, as expected.

A Republican alternative, put forth by Sen. Charles Grassley, R-Iowa, contains similar payment changes and support for e-prescribing, but differs from the Baucus bill in that it does not rely on deep cuts to privately run Medicare Advantage plans.

To date, only Snowe and Smith have crossed the aisle to support the Democratic version. The American Medical Association and other health care organizations have not been enthusiastic about the Grassley plan. And President Bush has threatened to veto the Baucus bill if it is passed.

With so little time left before the July 1 deadline, the impase is causing some in Congress to examine contingency plans. One idea is a six-month payment patch or other quick fix to extend the deadline for resolving the problem.

Another idea is to bite the bullet and accept the 10.6 percent cut on a short-term basis and work hard for a longer-term solution that would retroactively pay physicians for their losses during the period of pain.

"Whatever path Congress takes," an analysis posted on AmedNews said, "some physicians might see at least a few smaller Medicare checks before they are paid what lawmakers decide they deserve."

The AMA has been emphatic about its preference for the Baucus approach, pulling out all the stops to lobby for its passage.

"The AMA commends Chairman Baucus for his leadership in working to enact legislation that will stop looming Medicare physician payment cuts that begin in less than 30 days," said Edward L. Langston, MD, then chair of the AMA Board of Trustees.

"We look forward to reviewing the details of Senator Grassley's legislation to avert a Medicare access-to-care crisis as well," Langston said. "And we remain committed to final action before July 1 to ensure seniors' continued access to physician care."

At the AMA Annual Meeting this week in Chicago, state delegations like the MMA vowed to return to their states and turn up the heat in their own advocacy efforts.
AmedNews story