Democratic lawmakers call Bush administration's efforts to temporarily hold Medicare physician payment rates at current levels 'misleading'

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Democratic Sens. Jay Rockefeller (W.Va.) and Charles Schumer (N.Y.) in a letter to HHS Secretary Mike Leavitt wrote that there "have been several misleading -- and possibly incorrect -- reports from the [Bush] administration regarding actions on physician claims filed beginning July 1," The Hill reports (Young, The Hill, 6/30).

Leavitt on Friday said that the agency will maintain the current Medicare payment rate for physicians because Congress was unable to pass legislation before lawmakers left for the Fourth of July recess to avert a 10.6% cut scheduled to go into effect on Tuesday. Congressional aides said the freeze to payment rates could last 10 days (Kaiser Daily Health Policy Report, 6/30).

Rockefeller and Schumer wrote that the "administration is misleading the public by claiming to provide a 'temporary hold' on payment, which is already authorized by law, in order to give the appearance of being helpful to doctors in the Medicare program." They added, "Current law already requires that all Medicare claims submitted by physicians be withheld for 13 days prior to payment (for claims submitted electronically)" (The Hill, 6/30).

Pressure Increasing

Senate Majority Leader Harry Reid (D-Nev.) plans to bring up a House-passed bill (HR 6331) when the Senate returns from the recess that would delay the reduction to physician fees, CQ Today reports (Wayne, CQ Today, 6/30). In the Senate on Thursday, the measure failed by one vote to receive the 60 votes required to gain cloture. The House last month passed the measure by a veto-proof margin. The bill is similar to a measure (S 3101) proposed by Senate Finance Committee Chair Max Baucus (D-Mont.), which also failed to receive enough votes for cloture (Kaiser Daily Health Policy Report, 6/30).

The 10-business day delay in claims gives lawmakers -- who return from recess on July 7 --eight calendar days to pass legislation to curb the reduction in fees. Though the measure failed by just one vote to receive the 60 required to invoke cloture, it would require an additional eight votes -- a total of 67, provided all senators are present and voting -- to gain the two-thirds majority required to override a veto being threatened by President Bush.

Meanwhile, Sen. Edward Kennedy (D-Mass.), the only Democratic senator who did not vote, will not be returning to the Senate before the next vote because he is receiving cancer treatments after having a brain tumor removed, officials from his office said on Monday. Reid hopes that physician groups, such as the American Medical Association, will put pressure on Republicans to pass the bill (CQ Today, 6/30).

AMA President Nancy Nielsen said her group will employ a "full court press" on lawmakers over the recess. According to the Chicago Tribune, AMA is "formulating an advertising blitz to pressure several members of the Senate" to support the House measure. Although AMA has not announced where it will run the ads, sources close to AMA said that they will run them in states where Republican senators are facing re-election (Japsen, Chicago Tribune, 7/1).


Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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