The Medicare rules for the physician fee schedule (RB-RVS) would have mandated a 10% reduction for 2008 pursuant to the sustainable growth rate (SGR) formula. Congress postponed that for the first 6 months of 2008, but he 2nd 6 months is looming. Without actionmt he postmenement ends and the automatic 10.1% reduction kicks in automatically. The House has approved another reprieve. Quick Senate action is expected. Excerpts form the WSJ report follow.

Expect the current elected officials to enact the reprieve for the next 6 months and pass this problem on to the new administration.


House Clears Medicare Package

Bill Preventing Cuts
To Doctor Payments
Aims to Avoid Veto
June 25, 2008; Page A2

The House, with a lopsided 355-59 vote Tuesday, set up a complicated endgame for Medicare legislation that is expected to play out in the next few days.

[growing concern]

The bill would prevent a July 1 cut of 10.6% in Medicare fees paid to doctors. The White House has threatened a veto, largely because the bill would add restrictions on some private insurers’ versions of the government benefit for the elderly. The Senate is expected to move quickly to a vote on the House measure.

The maneuvers have been watched closely by Richard Bringewatt, who is fighting for the survival of a new type of private Medicare plan that targeted the chronically ill, a population that often gets inadequate care from the fragmented health system.

Five years ago, Mr. Bringewatt, who now heads the Special Needs Plan Alliance representing some 30 insurers, helped to persuade Congress to establish the plans, which cover more than 1.1 million people.

The issue is enmeshed in the Medicare legislation. Earlier, the Senate had fallen short of the 60 votes needed to move forward with a bill similar to the one that passed the House, but Tuesday’s strong bipartisan support in the House, where it got 129 Republican votes, has given it new momentum. On a parallel track in the Senate, lawmakers have also been crafting a compromise version aimed at avoiding a White House veto.

In the Senate, one sticking point has been the special-needs plans. Congress limited the plans’ expansion this year as it sought to define who — and what ailments — qualify for one type of plan targeting the chronically ill. The Bush administration wants Congress to renew the plans without restricting them only to the sickest patients.

The debate has implications for how care is provided to the most vulnerable senior citizens — a big concern for insurers, health-care providers and federal budgeters alike as the baby-boom generation ages.

In the Senate, lawmakers from both parties want to extend the special-needs plans through 2010. The Democrats’ bill, introduced by Senate Finance Committee Chairman Max Baucus of Montana would limit chronic-care plans to those with "complex, chronic conditions," a position the Bush administration opposes. Sen. Charles Grassley, the committee’s top Republican, has proposed limiting the plans’ expansion for another year while trying to find a middle ground.