House, Senate to Seek Agreement on Medicare, Medicaid Budget Package
From BNA’s Health Policy Report:
House and Senate negotiators the week of Dec. 12 are expected tobegin trying to find common ground between their two budgetreconciliation bills that reduce funding for Medicaid andMedicare.
The House is expected to return the week of Dec. 5, with the Senatedue back one week later. House and Senate negotiators will try toreach agreement on two very different health bills–both measurescontain Medicaid provisions, but only the Senate bill addressesMedicare.
After hours spent trying to ensure Republican support, the HouseNov. 18 narrowly approved the budget reconciliation bill (H.R. 4241),known as the Deficit Reduction Act of 2005, seeking nearly $11 billionin savings from the Medicaid program. The vote was 217 to 215.
The Senate approved its version of the budget reconciliation bill(S. 1932) Nov. 3 by a 52 to 47 vote. TheSenate bill would save $10 billion over five years from the Medicaidand Medicare programs.
Controversial Medicare Provisions.
Perhaps the two most controversial Medicare provisions in theSenate bill are a proposal to increase payments to doctors and to cutpayments to managed care plans.
The Senate package contains numerous Medicare provisions, includinga proposal to increase by 1 percent in 2006 Medicare payments tophysicians, at a cost of $10.8 billion over five years.
Unless Congress acts, under the current sustainable growth ratemethodology, physicians will receive a 4.4 percent cut in Medicarereimbursements beginning on Jan. 1, 2006, and payments would bereduced for several years after that as well.
At a Nov. 17 House Energy and Commerce Committee hearing, Centersfor Medicare & Medicaid Services Administrator Mark B. McClellantold lawmakers CMS would support a temporary payment hike for doctors.At a White House meeting the following day, McClellan and other Bushadministration officials asked doctor groups to find Medicare paymentoffsets to pay for the increase, according to industry sources.
Physician group sources say some in their ranks would be willing toaccept a zero percent payment update for two years if they getassurances that any pay-for-performance system for doctors would notfinancially penalize providers not initially meeting qualitystandards.
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Medicaid Modifications in House.
To garner sufficient support in the House for passage of the bill,the House Rules Committee Nov. 17 adopted a managers’ amendmentaffecting Medicaid eligibility and cost sharing. The changes raise thehome equity limit for determining Medicaid eligibility for nursinghome care to $750,000, compared to the $500,000 previously in thebill. In addition, the bill was modified to maintain the current $3copayment for Medicaid services.
However, the consumer group Families USA said the House bill’sMedicaid reforms remain harmful for poor Medicaid beneficiaries.”In their claim that these cuts are needed to improve the federalbudget–when, in fact, the combined benefit cuts and proposed new taxreductions for the rich will increase the deficit–House leaders aregiving cynicism a bad name,” Families USA Executive Director RonPollack said in a Nov. 18 statement. “It is our hope that thisinjustice is remedied as Congress moves to the last stages of thebudget process.”