CQ's Carey discusses Democratic, GOP Medicare proposals, VA mental health bill, health care IT measure

Mary Agnes Carey, associate editor of CQ HealthBeat, discusses Senate Democratic and Republican measures to halt a 10.6% reduction to Medicare physician fees; Senate legislation involving veterans' mental health; and a House bill that encourages greater adoption of electronic health records in this week's "Health on the Hill from kaisernetwork.org and CQ."

Last week, Senate Finance Committee Chair Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa) unveiled portions of their competing Medicare bills that would stop the physician fee reduction scheduled for July 1. Both measures would give physicians an increase, with Baucus' bill boosting pay by 1.1% for 18 months and Grassley's bill raising pay by 0.5% through the end of this year and by 1.1% in 2009. The measures contain other provisions, including payments for quality reporting and use of electronic prescribing. Baucus' bill also includes cuts to Medicare oxygen providers and a provision that would ensure pharmacists are paid promptly for dispensing beneficiaries' drugs. In addition, Baucus' bill would include cuts to Medicare Advantage private fee-for-service plans and indirect medical education payments. Grassley is expected to release funding details of his bill soon, according to Carey.

It is not clear whether either bill will have enough votes to pass in the Senate, according to Carey. Although lawmakers from both sides say that a bipartisan compromise is the only way to reconcile differences between the measures, it is unclear when or how this will happen, according to Carey. Carey writes that there should be a significant amount of action involving the bills in the next few weeks.

Carey also discussed Senate-approved legislation, sponsored by Senate Veterans' Affairs Committee Chair Daniel Akaka (D-Hawaii), that would address increasing cases of post-traumatic stress disorder and suicides among soldiers returning from Afghanistan and Iraq. The bill would expand care facilities and research on PTSD, in addition to substance use disorders and chronic pain. In addition, the measure would provide assistance for low-income and rural veterans and expand mental health resources to the families of veterans. It also would mandate that the Department of Veterans Affairs review its mental health infrastructure.

In addition, Carey addressed a recent hearing by the House Energy and Commerce Health Subcommittee on a bill that would encourage greater adoption of EHRs among physicians by authorizing loans and grants to assist with purchasing the technology. The legislation also would set standards for health IT equipment used by government programs, such as Medicare, with the intention of setting a precedent for the private industry. At the hearing, privacy advocates urged that the measure include strong protections of patients' privacy, according to Carey. Proponents of privacy protection want patients to have control over their records, but some industries involved, such as pharmacies and insurers, do not want protections to prevent them from being able to easily communicate with each other and patients. Beyond privacy issues, some lawmakers said the federal government should not pay for physicians to adopt EHRs, and some physicians are concerned about the cost of the technology, according to Carey.

The complete audio version of "Health on the Hill," transcript and resources for further research are available online at kaisernetwork.org.