White House Threatens Veto Of Medicare Legislation
06 12 07 - 00:00
HHS Secretary Mike Leavitt on Tuesday in a letter to the Senate Finance Committee wrote that White House advisers would recommend a veto of any Medicare legislation that includes cuts to Medicare Advantage plans or changes to the Medicare prescription drug benefit, CQ Today reports. The centerpiece of the Medicare legislation is the reversal of a 10% cut to physician fees, which is expected to cost several billion dollars. The Finance Committee has been drafting legislation that is expected "to rely heavily on the payments to private insurers" to stop the fee cut, according to CQ Today. A draft of the legislation has not been released.
Leavitt wrote that a veto would be recommended for any bill that "results in a loss of access to health care services, benefits or choices" in the MA program; "raises taxes ... to fund spending increases"; or alters Medicare's fiscal status by overturning administration regulatory decisions. Committee Chair Max Baucus (D-Mont.) said, "He knows there's no Medicare bill if there's no MA cuts. He knows there's no doctor fix if there's no MA cuts" (Armstrong, CQ Today, 12/4).
Health IT
Leavitt in his letter to the Finance Committee also requested that any change in physician fee cuts be linked to the adoption of health information technology, The Hill reports. Leavitt wrote that the legislation should "[c]ondition receipt of a portion of any fee adjustment to adoption of certified electronic health information technology," adding, "Physicians who do not adopt appropriate, available technology should receive a lower payment than those who do" (Young, The Hill, 12/5).
Leavitt in his blog on Monday wrote that physicians should adopt electronic prescribing and electronic health records to avoid Medicare fee cuts. Leavitt wrote that implementation of health IT that meets HHS standards would reduce medical costs and errors and be part of a long-term fiscal solution (Carey, CQ HealthBeat, 12/4).
Separately, Sens. John Kerry (D-Mass.), Debbie Stabenow (D-Mich.) and John Ensign (R-Nev.) on Wednesday are expected to introduce a stand-alone bill that would require adoption of e-prescribing for Medicare beneficiaries by 2011, CongressDaily reports. A senate aide said the bill would offer a 1% bonus for every e-prescription written and one-time funding for startup costs. Physicians who do not adopt the technology by 2011 would face financial penalties, the aide said. One- or two-year waivers would be available for physicians who have difficulty acquiring the technology necessary to write e-prescriptions.
Stabenow said she expects the Congressional Budget Office to find that the mandate would save $5 billion to $15 billion over 10 years. Congress' science adviser found that 1.5 million drug errors could be prevented annually by using e-prescribing and that it could save hospitals $3.5 billion in costs related to medication errors (Edney/Johnson, CongressDaily, 12/5).
Kerry, who sits on the Finance Committee, has said the e-prescribing mandate should be added to the Medicare bill (The Hill, 12/5).
Mark Up Likely Delayed
Finance Committee members want to mark up the Medicare package on Friday but still have "not agreed on the major issues," CongressDaily reports. Baucus must release a bill on Wednesday in order to mark it up on Friday, according to committee rules (Johnson, CongressDaily, 12/5). However, Republicans and Democrats cannot agree on whether to halt the fee cut for one or two years (Johnson, CongressDaily, 12/4). Republicans are concerned about how a two-year fix would be funded (Johnson, CongressDaily, 12/5).
Finance Committee ranking member Chuck Grassley (R-Iowa) on Tuesday said, "Things aren't completely worked out between Republicans and Democrats, and then with the Republican group, there are some points of contention that have to be worked out" (CongressDaily, 12/4).