December 7, 2007

Headline

Senate Moves to Negotiate Directly with House on Medicare Package

This week, Senate Finance Committee chairman Max Baucus (D-MT) announced that the Senate would forego committee and floor action on a Medicare bill and would instead negotiate with the House on the Medicare package. His announcement indicates Sen. Baucus was unable to reach agreement with Republicans on the committee on the cost of the Medicare package and how to pay for the legislation.

For the physician community, the Medicare bill is the last opportunity for Congress to avert the 10% cut in physician payments that will start on January 1, 2008. Leadership in the House and Senate have expressed strong support for averting cuts in Medicare physician payment.

The challenge is how to pay for fixing the Medicare sustainable growth rate (SGR) formula - the cause of the physician payment cuts. Under rules implemented under the Democratic controlled Congress - known as pay-go rules - any increase in federal entitlement programs must be offset with cuts in other federal spending. In the past, Congress has temporarily averted the next year's cuts by loading the costs of averted cuts into the out years - without fixing the underlying problem. This essentially makes the size of future year cuts bigger and increases the cost fixing in the underlying SGR.

The House has proposed a mix of cuts to Medicare Advantage (Medicare managed care programs) payments and Medicare oxygen reimbursement to pay for the Medicare bill. The White House has indicated it would veto legislation that cuts payments to Medicare Advantage plans. Senate Finance Committee members appear to be unable to agree on both the size of the Medicare package and most importantly how to pay for it.

The ATS and rest of the physician community will continue to advocate for a Medicare bill that provides positive Medicare physician payments for 2008 and 2009 and is paid for in a way that does not increase the cost of permanently fixing the SGR.

Pulmonary Rehabilitation

House and Senate Bills Pick Up Cosponsors

Both the House and Senate versions of the pulmonary rehabilitation legislation (S. 329/H.R. 552), introduced by Senators Crapo (R-ID) and Lincoln (D-AR) and Representatives Lewis (D-GA) and Pickering (R-MS), recently picked up additional cosponsors. The House bill now has 143 cosponsors with the addition of the following offices:

Rep. McHugh (NY)
Rep. Boyda (KS)
Rep. Carney (PA)
Rep. Woolsey (CA)
Rep. Shadegg (AZ)

The Senate bill now has 37 cosponsors with the addition of Sen. Mikulski (D-MD), Sen. Cardin (D-MD), and Sen. Coleman (R-MN).

The ATS will continue to work with Congress to include the pulmonary rehabilitation provision in any Medicare vehicle that moves through Congress.

Research

House & Senate to Finalize Compromise Health Package

Members of the House-Senate Labor-Health and Human Services and Education (Labor-HHS-ED) Appropriations conference committee are meeting this week to finalize the compromise package on fiscal year 2008 Labor-HHS-ED spending, including funding for the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC). In November, Congress sent the Labor-HHS-ED bill that included a 3.1% funding increase for the NIH to the president, which he vetoed. The Congress was not able to override the veto and must now work out a compromise package with the President that may include cuts to all or some programs before they adjourn for the year on December 21.

Although the details of how legislators will move forward and how the president will respond (possible veto) are unclear at this time, the ATS Washington Office action will be working to ensure that the NIH receives a funding increase as close as possible to the 3.1% increase, or $30 billion in total funding, included in the Labor-HHS Appropriations bill as passed by Congress.

ACTION: ATS members are asked to contact their Representatives and Senators to request their support for the 3.1% funding increase for the NIH. Visit the ATS website to learn if your Representative/Senator is a member of the House-Senate committee negotiating the final package at:

http://www.thoracic.org/sections/about-ats/advocacy/take-action-now.html

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