Preventing Pay Cuts to Medicare Doctors: Spring Update
Senate Finance Committee leaders are working on legislation to stabilize in the short term Medicare payments to physicians. ASTRO staff attended a meeting with specialty societies and learned that current plans are to spend between $15 billion and $18 billion over 18 months to avert a 10.6 percent cut scheduled for July 1 and an additional 5 percent cut on Jan. 1, 2009. However, this short-term fix would leave physicians facing as much as a 20 percent payment cut in 2010 without additional action. Senate Finance Chairman Max Baucus (D-Mont.) has not announced how he plans to fund the bill, although he has not ruled out cutting Indirect Medical Education paid to Medicare Advantage plans.
In order to avoid disruptions in payments and additional administrative fees, the Bush administration has said Congress must pass a Medicare bill and send it to President Bush by June 16. Due to the Memorial Day recess, this would give Congress only two weeks to approve the bill. While there is broad congressional support to stop the 10.6 percent payment cut, there has been no agreement on how to pay for this fix and no legislative action has taken place yet.
ASTRO will continue to monitor this situation as events rapidly develop leading up to the July 1 deadline.
Children’s Health and Medicare Protection (CHAMP) Act (HR 3162) Passed by House
On August 1, the House passed the Children’s Health and Medicare Protection (CHAMP) Act (HR 3162) by a largely party-line vote of 225 to 204. The bill, which includes important language for radiation oncology and is supported by ASTRO, would expand the children’s health insurance program, avert a 9.9 percent cut in Medicare physician payments scheduled for January 1, 2008, and replace the sustainable growth rate formula with new spending targets covering six physician service areas.
ASTRO achieved a major legislative victory by securing critical committee report language accompanying the CHAMP Act that recognizes the distinction between radiation therapy services and diagnostic medical imaging. According to the committee’s report, “While medical imaging is a component of radiation oncology procedures, these services are not considered to be imaging services." This recommendation would prevent radiation oncology procedures from being included in the spending target group for imaging services;an area that could face significant cuts if the bill is enacted.
During the August recess, staff from the House and Senate, which passed a smaller children’s health insurance expansion without Medicare changes this week, will begin working out the many differences between the two packages informally. When Congress returns after Labor Day, the official conference will begin. Although it is far from certain what provisions will be contained in the final package, vote counts in both the House and Senate have begun, and there is some speculation that Congress may be able to override a presidential veto. The President issued a veto threat on the CHAMP Act, objecting to the bill’s SCHIP expansion, cuts to Medicare Advantage, increased the tobacco tax and other issues.
ASTRO strongly encourages you to capitalize on the opportunity to meet locally with your Senators and Representatives to discuss important healthcare issues, including Medicare payments and funding for cancer research, during the August congressional recess. Please find information below to meet with your Members of Congress at their local offices or at Town Hall meetings during the August recess.
Get Ready for PQRI
The Medicare Physicians Quality Reporting Initiative (PQRI) starts July 1, and ASTRO encourages participation in this voluntary program. Those who choose to report data on the approved quality measures during the six-month period starting July 1, 2007, until December 31, 2007, are eligible for a 1.5 percent bonus, subject to a cap, on all of their Medicare charges during that time. For more info, go to http://www.cms.hhs.gov/PQRI or click on this presentation from ASTRO Advocacy Day 2007.