TWICNOV2009

TheWeekInCongress.com - November 19, 2009 - The House passed, 243 to 183 a bill that would revise the formula for payments to physicians serving Medicare beneficiaries and removes the current law provision that would cut those payments by 21% January 2010.

The bill is part of the foundation upon which the current healthcare legislation, HR 3962, is being built.

CBO reports that the change will cost taxpayers $210 billion over ten years but there will be no increases in Medicare Part B premiums until 2011. The estimated increase at that time is $49 billion.

On passage the text of H.R. 2920, the Statutory PAYGO Act of 2009, (passed by the House on July 22nd) will be added as new matter at the end of the bill before being sent to the Senate. The addition ensures that the changes must be paid for by spending cuts elsewhere or by an increase in tax or other revenues. The increase of payment for 2010 would not be subject to the PAYGO rule because those payments have already been established by a previous Congress and would not increase them beyond what is already established by law.

The Majority notes that the bill reverses a trend established during the Republican controlled Congress referred to as "a budget gimmick that artificially reduces the deficit by assuming physician payments will be cut by 40 percent over the next several years even though Congress has consistently intervened to prevent those cuts from occurring."

The 21% cut is cumulative since 1997 when the SGR formula was passed by Congress as a balanced budget enforcement mechanism. Since then, however, the cuts have been forestalled. Each year the required cut grew larger resulting in the 21% cut due this January.

Bill points provided by the Majority:

Preserves seniors’ access to their doctors with a guaranteed update in 2010. Replaces the pending 21 percent fee cut with an update for 2010 based on the Medicare economic index while a new payment system is being put in place.
Fairer growth targets to keep doctors’ pay steady. Wipes away accumulated deficits from current spending targets to provide for a fresh start, but still holds physicians accountable for spending growth. Excludes items not paid under the Medicare physician fee schedule such as chemotherapy drugs and laboratory services from revised growth targets.
Promotes primary care that can keep you healthier longer. Provides an extra growth allowance for primary care services to promote access to primary care practitioners in Medicare and throughout the health care system.
Encourages integrated care so your doctors communicate on your care. Encourages the formation of Accountable Care Organizations which incentivize physicians to take responsibility for improving quality and reducing costs. Accountable Care Organizations may “opt out” of the national spending targets and establish their own organization-specific targets.

HR 3961 -- bill report and votes.

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Bills Seek FDR Memorabilia; Extend US authority to address crimes on cruise ships; Establish requirements for preventing non-indigenous species entering the US on boat hulls;

FDR Documents

US sets rules for donating FDR documents to avoid court action.

HR 1506

Cruise Ship Safety

Sexual assault and missing persons at sea prompt extending US authority to respond.

HR 3360

Clean Hulls

Vessels, commercial and recreational, would be required to prevent growth on hulls.

HR 3618

The House will be in session on December 1st.

The Senate is in session.