The Senate passed key legislation July 9 that forestalls a 10.6% cut in Medicare physician payments following intense lobbying from patient and physician advocacy groups over the Independence Day Congressional recess. The 69-30 tally in favor of the bill makes it veto-proof.
The Medicare Improvements for Patients and Providers Act of 2008 (HR 6331) replaces the 10.6% payment cut scheduled by Medicare’s Sustainable Growth Rate formula that would have become effective July 1 with a 0.5% payment raise for the remainder of 2008. HR 6331 also repeals an additional 5% cut set for Jan. 1, 2009, and provides instead a 1.1% increase.
The bill requires providers of advanced imaging services such as CT, MRI, and PET to be accredited by 2012 to receive payments. HR 6331 also establishes a two-year voluntary appropriateness criteria evaluation program.
“The American College of Radiology is gratified that Congress has acted to preserve access to care for our nation’s seniors by averting this drastic reimbursement cut and at the same time increasing the quality of those services by enacting quality and safety standards for medical imaging providers,” said Dr. James H. Thrall, chair of the ACR Board of Chancellors.
The imaging provisions and accreditation requirements will bolster the overall quality of practice and ensure that Medicare beneficiaries receive consistent care nationwide, according to Thrall.
The approved legislation will also phase out indirect medical education subsidies that Medicare currently pays to Medicare Advantage plans run by private insurers, said Orrin Marcella, ACR director of congressional affairs. It will eliminate the ability of private fee-for-service Medicare Advantage plans to automatically deem a physician in its network without a contract in areas where more than one of these plans exist.
Senate Republicans had resisted the legislation because it offsets the cuts with a reduction in subsidies to private insurers who offer Medicare Advantage plans, and the Bush administration has repeatedly threatened to veto the bill due to this provision. The House overwhelmingly approved HR 6331 in late June with a 355-59 vote, but the bill required 60 votes to pass out of the Senate and 67 to make it veto-proof.
Ailing Sen. Edward Kennedy (D-MA) was hailed as the hero of the session after he flew to Washington, DC, yesterday in the midst of treatments for brain cancer to cast the crucial vote. In the end, 18 Republicans joined the 49 Senate Democrats and two independents to approve the legislation.
“The American people have a hero today,” said Senate Finance Committee chair Max Baucus (D-MT).
Baucus cited Kennedy’s role in leading the Senate to save Medicare from a true crisis by voting to reverse the physician payment cut that threatened seniors’ access to care and healthcare for military families. The approved $4 billion will help rural and low-income seniors and provide a host of improvements for Medicare beneficiaries, Baucus said.
“The imaging standards and the appropriateness criteria pilot program included in this bill will improve the quality of care that our nation’s seniors receive, and the physician reimbursement updates will help protect the ability of physicians to continue to provide care. The ACR urges President Bush to sign this bill into law,” Thrall said.