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Houses Passes Medicare Bill

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The House today voted 355-59 to pass a bill, H.R. 6331, that would cut Medicare Advantage program funding by $13.8 billion over 5 years and impose new restrictions on marketing of Medicare Advantage programs.

If Congress does not pass some kind of bill quickly, current law calls for Medicare to cut payments to physicians 10.6% starting July 1.

Many members of Congress hope to give physicians modest pay increases over the next 18 months.

Senate Finance Committee leaders recently failed to come up with a Medicare Advantage funding and physician reimbursement bill.

The House bill incorporates cuts in Medicare Advantage proposed in a bill introduced by Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee, on behalf of Senate Democrats.

Sen. Charles Grassley, R-Iowa, the highest ranking Republican member of the Senate Finance Committee, proposed cuts of $9.9 billion in his version of the bill.

Ira Loss, an analyst at Washington Analysis, Washington, says the Senate is unlikely to rubber-stamp the House bill, H.R. 6331, before going on its July 4th recess Friday.

“We continue to believe the two camps will reach a smaller compromise (likely about $15 billion) on the Medicare legislation later this summer and retroactive to July 1,” Loss said.

“We still believe that there is a common desire for an 18-month fix and other changes,” Loss said. “As we said previously, we expect the compromise bill to include a 5-year savings of about $10 billion from Medicare Advantage” through a phase-out of payments to teaching hospitals; tapping the Medicare Advantage stabilization fund; and codifying a ban on marketing, he says.

Officials at America’s Health Insurance Plans, Washington, and the National Association of Health Underwriters, Arlington, Va., criticized the House vote, objecting both to Medicare Advantage funding cuts and to the sales practices provisions.

AHIP President Karen Ignagni says the House rushed H.R. 6331 through a vote and contends that the bill would require Medicare Advantage beneficiaries “to pay for the increase in physician payments without considering the impact these cuts would have on vulnerable seniors.”

Ignagni says the cuts represent 94% of the bill’s overall direct budget cuts, not including interactions, and 73% of the budget cuts if interactions are counted.

NAHU Executive Vice President Janet Trautwein has written in letters to leaders in both the House and Senate to say that she has “grave concerns” about the proposed Medicare Advantage sales practices rules.

Trautwein says lawmakers should wait for the Centers for Medicare and Medicaid Services to complete a rule making process that is already under way.

“We fervently believe that CMS’s rule making process with its full and open public comment period for all stakeholders should be allowed to move forward.” Trautwein says.

“Statutory changes at this time similar to the reforms CMS is proposing are unnecessary and unlikely to consider fully the broad range of dynamics and many nuances involved in selling and servicing products to America’s seniors,” Trautwein says. “Statutory changes may, in fact, complicate and be inconsistent with ongoing rule making.”


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