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History of 2008 Medicare Payments to Physicians
July 16, 2008 - Congress Overrides Bush's Medicare Veto
We are very happy to report that both the House and Senate voted to override President Bush's veto of H.R. 6331, the “Medicare Improvements for Patients and Providers Act of 2008. The House took up the measure at about 4:50 p.m. yesterday afternoon and successfully passed it by a vote of 383-41. Although all 41 Representatives voting against the override were Republicans, this represents a gain in party support since the last House vote. All three of West Virginia's Representatives (Capito, Mollohan and Rahall) voted in favor of the override!
The Senate then quickly voted at about 6:25 p.m. yesterday evening. The final vote was 70-26, more than the required two-thirds majority of the Senators present. Once again, all those who voted against the override were Republicans, although from listening to the roll call we appear to have picked up four new Republican supporters, including Senators Christopher Bond (R-MO), Thad Cochran (R-MS), Richard Lugar (R-IN), and Roger Wicker (R-MS). Both of West Virginia's Senators (Byrd and Rockefeller) voted in favor of the override!
This truly was a bipartisan effort to preserve patient access to care. H.R. 6331 will now become law.
The legislation specifies that the 0.5 percent payment update for the remainder of 2008 becomes effective July 1, so the 10.6 percent cut that was to be reflected in claims paid this week will be canceled (although payments made in the immediate future for services provided on or after July 1 will include the cut). The most current information available on claims processing and payment adjustment issues is posted on the home page of the AMA’s web site, and will be updated as more details become available.
President Bush's veto message centered on objections to the Medicare Advantage changes and a newly raised concern about provisions pertaining to the Medicare prescription drug program. Of particular interest, you will note his objections to reliance on a “short-term budget gimmick” that do not solve the problem. The AMA has called for a long-term solution to the Medicare payment problems.
PLEASE! If you haven't done so already, please use the AMA Grassroots Hotline at (800) 833-6354 to send a quick THANK YOU to your Senators and Representative for standing up for West Virginia's physicians and patients. Using the hotline is very quick and easy.
A short phone call is the least WV physicians can do to say thanks for saving each of you on average $19,000 annually.
July 15, 2008 - President Vetoes Medicare Bill - Congress Set to Override
Just a short while ago in an anticipated move, President Bush vetoed HR 6331, the Medicare Physician payment bill. Now Congress is set to attempt a veto override. The House vote could occur as early as this afternoon, with the Senate acting rapidly afterwards.
Both the U.S. Senate and the House of Representatives passed the bill (H.R. 6331) to stop the 10.6 percent Medicare physician payment cuts that took effect July 1. The measure would replace the scheduled cuts to Medicare’s physician pay rates with 18 months of stable payments (.5 percent increase for remainder of 2008 and 1.1 percent increase for 2009). The cost would be offset by cutting bonus payments to private Medicare plans known as Medicare Advantage. Those cuts total $12.5 billion over five years, according to the Congressional Budget Office.
For a summary of the legislation click here.
The House passed the bill, 355-59, on June 24. The Senate passed it by voice vote July 9 after voting 69-30 to overcome a procedural hurdle. Both chambers have more than enough votes to override the president, assuming no members change their votes.
West Virginia's entire delegation has voted solidly in support of this legislation. It is critical now that physicians contact their Senators and Representatives to THANK THEM for standing up for physicians and patients and to ASK THEM to vote to override the veto.
You may click below to send an email or use the AMA Hotline (800) 833-6354 and be easily patched into your Senator or Representative's office.
What are the impacts of the Medicare physician payment cuts in West Virginia?
• West Virginia physicians will lose $80 million for the care of elderly and disabled patients over the 18 months from July 2008 through December 2009 due to a 10.6 percent cut in Medicare payments in July 2008 and an additional 5 percent cut in 2009. On average, each West Virginia physician faces a Medicare cut of $19,000 over this 18-month period. In addition, the state’s physicians will lose $1.6 billion for the care of elderly and disabled patients by 2016 due to nearly a decade of cuts for this important medical care.
• 18,501 employees, 343,374 Medicare patients and 35,262 TRICARE patients in West Virginia will be affected by these cuts.
• Compared to the rest of the country, West Virginia, at 19 percent, has the highest proportion of Medicare patients of any state and, at 22 percent, also has an above-average proportion of disabled beneficiaries. In addition, at 13 practicing physicians per 1,000 beneficiaries, has one of the lowest ratios of physicians to Medicare beneficiaries, even before the cuts take effect.
• 44 percent of West Virginia’s practicing physicians are over 50, an age at which surveys have shown many physicians consider reducing their patient care activities.
• In July 2008, West Virginia physicians face cuts of an additional 1.5 percent on top of the 10.6 percent cuts across the country. The 2003 Medicare law provided a temporary increase in geographic payment adjustments for certain states. This increase also will expire on June 30, 2008 under current law.
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http://www.votervoice.net/link/target/wvsma25925670.aspx
July 10, 2008 - Senate Passes Medicare Physician Payment Fix!
We are happy to report that early yesterday evening the Senate passed H.R. 6331, the “Medicare Improvements for Patients and Providers Act of 2008,” by a veto-proof majority of 69-30!
Senator Edward Kennedy (D-MA) entered the chamber midway through the roll call to cast his vote in favor of the bill—his first appearance in the Senate since his operation in early June. Eighteen Republican Senators joined the Senate Democrats to make this a truly bipartisan process. (The actual roll call vote follows at the end of this message.)
As you know, the legislation replaces the 10.6% payment cut that went into effect on July 1 with a 0.5% update extension through December 31, 2008. For calendar year 2009, the update will be 1.1%. Other important provisions such as extending the GPCI floor on physician work were also included.
The bill must now be signed into law by President Bush, who has signaled on more than one occasion that he intends to veto it. However, given the fact that the payment cuts have already occurred and that the bill passed both chambers with the two-third majority needed to override a veto, there is some reason to question next steps by the White House.
Both Senators Byrd and Rockefeller voted yes on this measure.
Please click the link at the bottom of this message to send a THANK YOU! note to both Senators and a message to President Bush urging him to sign this bill into law!
Vote Summary
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Question: On the Cloture Motion (Upon Reconsideration, Motion to Invoke Cloture on the Motion to Proceed to Consider H.R. 6331 ) |
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Vote Number: |
169 |
Vote Date: |
July 9, 2008, 04:11 PM |
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Required For Majority: |
3/5 |
Vote Result: |
Cloture Motion Agreed to |
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Measure Number: |
H.R. 6331 (Medicare Improvement for Patients and Providers Act of 2008 ) |
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Measure Title: |
A bill to amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes. |
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Vote Counts: |
YEAs |
69 |
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NAYs |
30 |
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Not Voting |
1 |
Grouped By Vote Position
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YEAs ---69 |
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Akaka (D-HI)
Alexander (R-TN)
Baucus (D-MT)
Bayh (D-IN)
Biden (D-DE)
Bingaman (D-NM)
Boxer (D-CA)
Brown (D-OH)
Byrd (D-WV)
Cantwell (D-WA)
Cardin (D-MD)
Carper (D-DE)
Casey (D-PA)
Chambliss (R-GA)
Clinton (D-NY)
Coleman (R-MN)
Collins (R-ME)
Conrad (D-ND)
Corker (R-TN)
Cornyn (R-TX)
Dodd (D-CT)
Dole (R-NC)
Dorgan (D-ND) |
Durbin (D-IL)
Feingold (D-WI)
Feinstein (D-CA)
Harkin (D-IA)
Hutchison (R-TX)
Inouye (D-HI)
Isakson (R-GA)
Johnson (D-SD)
Kennedy (D-MA)
Kerry (D-MA)
Klobuchar (D-MN)
Kohl (D-WI)
Landrieu (D-LA)
Lautenberg (D-NJ)
Leahy (D-VT)
Levin (D-MI)
Lieberman (ID-CT)
Lincoln (D-AR)
Martinez (R-FL)
McCaskill (D-MO)
Menendez (D-NJ)
Mikulski (D-MD)
Murkowski (R-AK) |
Murray (D-WA)
Nelson (D-FL)
Nelson (D-NE)
Obama (D-IL)
Pryor (D-AR)
Reed (D-RI)
Reid (D-NV)
Roberts (R-KS)
Rockefeller (D-WV)
Salazar (D-CO)
Sanders (I-VT)
Schumer (D-NY)
Smith (R-OR)
Snowe (R-ME)
Specter (R-PA)
Stabenow (D-MI)
Stevens (R-AK)
Tester (D-MT)
Voinovich (R-OH)
Warner (R-VA)
Webb (D-VA)
Whitehouse (D-RI)
Wyden (D-OR) |
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NAYs ---30 |
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Allard (R-CO)
Barrasso (R-WY)
Bennett (R-UT)
Bond (R-MO)
Brownback (R-KS)
Bunning (R-KY)
Burr (R-NC)
Coburn (R-OK)
Cochran (R-MS)
Craig (R-ID) |
Crapo (R-ID)
DeMint (R-SC)
Domenici (R-NM)
Ensign (R-NV)
Enzi (R-WY)
Graham (R-SC)
Grassley (R-IA)
Gregg (R-NH)
Hagel (R-NE)
Hatch (R-UT) |
Inhofe (R-OK)
Kyl (R-AZ)
Lugar (R-IN)
McConnell (R-KY)
Sessions (R-AL)
Shelby (R-AL)
Sununu (R-NH)
Thune (R-SD)
Vitter (R-LA)
Wicker (R-MS) |
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Not Voting - 1 |
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McCain (R-AZ) |
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http://www.votervoice.net/link/target/wvsma25763534.aspx
July 3, 2008 - Please watch the video from AMA president Dr. Nielsen urging physicians to contact their senators to address the Medicare payment issue. You can also call the AMA HOTLINE: (800) 833-6354
July 1, 2008 - Medicare Physician Payment Cut Update
As you already know, Congress adjourned for their Independence Day holiday without acting to stop the impending Medicare cuts prior to the July 1 deadline. Despite organized medicine's best efforts, the US Senate failed to garner enough votes to pass legislation halting the cuts. Starting today CMS would have initiated the processing of claims with a 10.6% reduction. However, CMS issued a statement late yesterday afternoon to members of Congress announcing they have made the decision to hold all claims for 10 days in order to give Congress more time to pass a bill. The following is the statement issued yesterday by CMS:
"We apologize for sending a notification during Congressional recess. However, we have received numerous questions throughout the day regarding how we will handle physician claims in the coming days. Therefore we want to share the following information as soon as possible.
To the extent possible, CMS wants to work with Congress, health care providers and the beneficiary community to avoid any disruption in the delivery and payment of physician and non-physician practitioner services beginning on July 1. In this regard, the agency plans to instruct its contractors to not process any physician and non-physician practitioner claims for the first 10 business days of July. Under current law, electronic claims are not to be paid any sooner than 14 days (29 days for paper claims) and not later than the 30th day they are submitted (otherwise, CMS must pay interest on those claims). By holding claims for health care services that are delivered on or after July 1, CMS will not be making any payments on the 10.6 percent reduction until July 15, at the earliest. Meanwhile, all claims for services delivered on or before June 30 will be processed and paid in regular order. ..."
The WVSMA is watching this issue closely and will share any new developments with our members as we receive the information. In the mean time it is critical to continue urging our members of Congress to find a way to stop these impending cuts.
June 27, 2008 - Senate Fails to Pass Medicare Payment Fix 2nd Time
Last night, by a vote of 58 to 40, the US Senate failed to proceed to and adopt the "Medicare Improvements to Patients and Providers Act" (H.R. 6331). 60 votes were needed to pass the bill. In a procedural move, Sen. Reid changed his vote to "No" so that he could call the bill up at a future date. Therefore the measure fell one vote short of being adopted.
Vote Count Information:
Question: On the Cloture Motion (Motion to Invoke Cloture on the Motion to Proceed to Consider H.R. 6331 )
Vote Number: 160
Vote Date: June 26, 2008, 08:20 PM
Required For Majority: 3/5 Vote
Result: Cloture Motion Rejected
Measure Number: H.R. 6331 (Medicare Improvements for Patients and Providers Act of 2008 )
Measure Title: A bill to amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes.
Vote Counts: YEAs 58
NAYs 40
Not Voting 2
Both Senator Robert Byrd and Senator Jay Rockefeller voted yes on this measure. Please click below to send them an email thanking them for voting yes on HR 6331 and ask them to continue working to push their coleagues to address this issue!
Below is a press release issued by the AMA this morning:
For Immediate Release June 27, 2008
AMA OUTRAGED AT SENATORS WHO PUT HEALTH INSURERS BEFORE MEDICARE PATIENTS
Statement Attributable to: Nancy H. Nielsen, M.D., President, American Medical Association
“The physicians of America are outraged that a group of Republican senators followed the direction of the Bush Administration and voted to protect health insurance companies at the expense of America’s seniors, disabled and military families. “These senators leave for their 4th of July picnics knowing that the most vulnerable Americans are at risk because of the Senate's inability to act to stop drastic payment cuts for health care services that are needed by our Medicare and TRICARE patients.
“The House voted to preserve access to care for Medicare patients in a bipartisan landslide vote to pass H.R. 6331 by an overwhelming margin of 355 to 59. The House made seniors, the disabled and military families a top priority. The AMA appreciates the courage of the 59 Senators, including 9 Republicans, who voted to put patients ahead of partisan politics and vote for H.R. 6331.
“Today, thanks to some senators, we stand at the brink of a Medicare meltdown. On July 1 – just four days from now – the government will slash Medicare physician payments by 10.6 percent, forcing many physicians to make the difficult choice to limit the number of Medicare patients in their practices.
“The Senate must return from their recess and make seniors’ health care their top priority. For doctors, this is not a partisan issue - it's a patient access issue.”
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June 24, 2008 - US House Just Passed Medicare Improvement Act!
Thanks to tremendous efforts by the physicians in West Virginia and across the nation, important developments are taking place today in Congress as we work to stop the Medicare physician payment cut that is scheduled to occur on July 1.
Under suspension, the House of Representatives passed HR 6331, the "Medicare Improvements for Patients and Providers Act of 2008," on a vote of 355 to 59 - more than the two-thirds majority needed to pass legislation under this expedited procedure. A majority of Republicans (115) joined House Democrats in approving the bill, with 59 Republicans voting in opposition.
All three of West Virginia's representatives, Capito, Mollohan and Rahall, voted YES!
Please contact your representative to tell them THANK YOU for voting Yes on HR 6331. You may use either the AMA's hotline at (800) 833-6354 or click the link below to send an email. It is important that they hear from the physician community that we appreciate their actions on behalf of physicians and patients.
Introduced by Ways and Means Committee Charles Rangel (D-NY) and Energy and Commerce Committee chair John Dingell (D-MI), H.R. 6331 would forestall the 10.6 percent Medicare cut on July 1 by extending the current 0.5 percent update through the end of 2008 and implementing a 1.1 percent update for calendar year 2009. Very similar legislation introduced by Senate Finance Committee chair Max Baucus (D-MT), S. 3101, was brought to the Senate floor on June 12 but failed to gain the 60 votes required to initiate debate.
Like the original Baucus legislation, HR 6331 shares financing mechanisms that led to the threat of a Presidential veto and the Senate's failure to obtain the 60 votes required to avoid a filibuster--namely, decreased federal spending for Medicare Advantage plans. As of 1:00 Eastern time on June 24, it is uncertain what the next steps will be in the Senate.
The House leadership is also considering next steps, since today's vote has confirmed that the majority of legislators in both the House and Senate support key provisions affecting Medicare physician payments, such as replacing the July 1 cut with 18 months of positive payment updates, and that they are willing to reduce support for Medicare Advantage plans in order to accomplish this goal.
While the AMA and the WVSMA have demanded much of our grassroots in recent weeks, it is critical that the physician community maintain pressure on their legislators if we are to succeed in reaching our goal of reasonable payment updates over a period of time that will allow us to develop and pass true and lasting Medicare payment reform.
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