Friday, June 27, 2008

Medicare Cuts

Congress failed to stop the 10.6% Medicare cut.

Dear Friends and Colleagues:
Unfortunately, by a vote of 58 to 40 the Senate failed to follow the example of the House and adopt H.R. 6331 - the “Medicare Improvements to Patients and Providers Act”
60 votes were needed to pass the bill. In a procedural move, the Senate Majority Leader Harry Reid (D-NV) 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.
Lobbyist and representatives of our American Medical Association worked VERY hard to fight the looming Medicare cuts, but our elected officials voted against our interests.

Our AMA issued the following press release:

“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."


U.S. Senator Mel Martinez voted AGAINST the bill, U.S. Senator Bill Nelson voted FOR the bill,.

“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 nine 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."

What can we do now?

* Call upon our Senators to 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.
* Call Senator Bill Nelson to congratulate him for his courageous support of this bill Phone# 202 224-5274 or 305 536-5999.
* Call Senator Mel Martinez and advise him that his position has been duly noted and that we will inform our patients accordingly Phone#202 224-3041 or 305 444-8332
* Limit non-urgent Medicare appointments until congress acts and reverses the cut and inform our patients why we are forced to take those steps.
* Hand out information to our patients asking them to call their representatives to protest the looming drastic Medicare cuts
* Join your county, state and national medical association to support our efforts protecting your interests.

NOW is the time to act as a group! Our patients access to health care services is at stake and we have to stop private insurance companies from pocketing Medicare dollars.

Bernd Wollschlaeger,MD,FAAFP,FASAM
President, Dade County Medical Association

Thursday, June 12, 2008

Medicare Cuts and The Senate Vote Today

Dear Friends and Colleagues:

Today, Senate Bill 3101 "The Medicare Improvements for Patients and Providers Act " sponsored by Senator Baucus failed to gather enough support in the Senate for a closure vote.

It includes provisions to address serious, long-standing Medicare problems faced by millions of seniors on fixed incomes struggling every day with rapidly rising Medicare, food, and gasoline costs.
CBO (Congressional Budget Office) estimates that S. 3101 with that proposed amendment would increase spending on physicians’ and other services by $19.8 billion over the 2008-2013 period and
$62.8 billion over the 2008-2018 period; those amounts would be offset by reductions in payments to other providers (primarily Medicare Advantage plans). Taken together, the bill would reduce direct spending by $5 million over both the 2008-2013 and 2008-2018 periods, CBO estimates. S. 3101, when amended, would avert a reduction to Medicare’s physician fee schedule planned for July 1, 2008, by freezing those fees at their current levels for the remainder of the year and increasing them by 1.1 percent in January 2009. Beyond 2009, fees would be held at their current-law levels, necessitating a 21 percent reduction in 2010. The bill would also extend many expiring provisions of Medicare, expand Medicare’s coverage of preventive services, and modify the rules governing eligibility for the Medicare Savings Program. New spending under the bill would be offset largely by reductions in payments to and enrollment in Medicare Advantage plans. The bill, with the amendment, would phase out double payments for indirect medical education made to plans and hospitals for Medicare Advantage enrollees. It also would require private fee-for-service plans to adopt networks, with some exceptions, leading to decreases in enrollment and reduced outlays.

Senators who opposed the Baucus bill argued that the improvements for poor seniors were fiscally irresponsible, yet supported increased payments to physicians.
Those opposing SB 3101 support a legislation offered by Sen. Charles Grassley (R-IA).

Sen. Charles Grassley (R-Iowa) on Wednesday introduced the Preserving Access to Medicare Act of 2008, legislation intended to postpone a scheduled 10.6 percent reduction to Medicare physician payments. Sen. Grassley said the cuts would likely affect seniors’ access to physicians. Under Grassley’s bill, a 0.5 percent physician update would be provided for the rest of 2008. That percentage would increase to 1.1 percent for 2009. To help pay for the plan, the bill would cut over the next five years roughly $12.5 billion from privately run Medicare Advantage plans.
The measure also offers incentive payments to healthcare professionals for using a qualified e-prescribing system. Rural home health agencies would see a five percent home health add-on payment for 2009, and starting Jan. 1, certain skilled nursing facilities would be included as originating sites for the telehealth services initiative.
Sen. Grassley said that unlike similar legislation introduced by Sen. Max Baucus (D-Mont.), his bill was far more likely to be signed into law because it “does not make large, unwarranted cuts to Medicare Advantage.”

The Baucus bill, the Patients and Providers Act of 2008 (S. 3101), would cut roughly $13 billion from the private Medicare Advantage plans.

Personally, I favor the Baucus plan but I am mindful and realistic that it would have been vetoed by President Bush and in the absence of a veto-proof majority would have died anyway.
Nevertheless, its failure demonstrates who are our friends and foes in the Senate.
From Florida Senator Martinez voted AGAINST the Baucus bill and we should send him a letter reminding him that Florida's seniors are a strong voting block and will exercise their right to vote in 2010 when his term will expire.
Let's remind our Senators that their attitude and position regarding Medicare reimbursement for physicians will be monitored by us!!

Yours truly,



Grouped By Vote PositionYEAs ---54

Akaka (D-HI)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)Coleman (R-MN)Collins (R-ME)Conrad (D-ND)Dodd (D-CT)Dole (R-NC)Dorgan (D-ND)Durbin (D-IL)Feingold (D-WI)Feinstein (D-CA)Harkin (D-IA)Johnson (D-SD)Kerry (D-MA)Klobuchar (D-MN)Kohl (D-WI)Lautenberg (D-NJ)Leahy (D-VT)Levin (D-MI)Lieberman (ID-CT)Lincoln (D-AR)McCaskill (D-MO)Menendez (D-NJ)Mikulski (D-MD)Murkowski (R-AK)Murray (D-WA)Nelson (D-FL)Nelson (D-NE)Pryor (D-AR)Reed (D-RI)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)Webb (D-VA)Whitehouse (D-RI)Wyden (D-OR)

NAYs ---39

Alexander (R-TN)Allard (R-CO)Barrasso (R-WY)Bennett (R-UT)Bond (R-MO)Brownback (R-KS)Bunning (R-KY)Burr (R-NC)Chambliss (R-GA)Coburn (R-OK)Cochran (R-MS)Corker (R-TN)Cornyn (R-TX)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)Hutchison (R-TX)Inhofe (R-OK)Isakson (R-GA)Kyl (R-AZ)Lugar (R-IN)Martinez (R-FL)McConnell (R-KY)Reid (D-NV)Sessions (R-AL)Shelby (R-AL)Thune (R-SD)Vitter (R-LA)Voinovich (R-OH)Warner (R-VA)Wicker (R-MS)

Not Voting - 7
Clinton (D-NY)Inouye (D-HI)Kennedy (D-MA)Landrieu (D-LA)McCain (R-AZ)Obama (D-IL)Sununu (R-NH)