Prospects Uncertain For Actions On Health Care IT Bill, Medicare Physician Payment Rate

The chances of Congress passing bills on health care information technology and Medicare physician reimbursement rates "remain uncertain," CongressDaily reports. According to the CongressDaily, negotiations on the bills "will remain largely behind the scenes at the beginning of the week, with any public action likely to come in the final days before Congress breaks" (CongressDaily, 9/25). Lawmakers plan to recess at the end of this week and return briefly after the Nov. 7 elections to finish some work. Republican congressional leaders "have decided to dedicate the session's few remaining days to their most pressuring, highest-profile issues, such as immigration, military spending and homeland security to the exclusion of almost everything else" -- including such health care issues as the scheduled reduction in Medicare physician reimbursements, the Washington Post reports (Birnbaum, Washington Post, 9/24).

IT Legislation
The health care IT legislation "has the most promising prospects for passage before recess," according to CongressDaily (CongressDaily, 9/25). The health care IT bill (HR 4157), which was approved by the House on July 27, would codify the Office of the National Coordinator for Health Information Technology within HHS; establish a committee to make recommendations on national standards for medical data storage; and develop a permanent structure to govern national interoperability standards. The bill also would clarify that current medical privacy laws apply to data stored or transmitted electronically and would require the HHS secretary to recommend to Congress a privacy standard to reconcile differences in federal and state laws. Under the bill, the number of billing codes health care providers use to file insurance claims would increase from 24,000 to more than 200,000 by October 2010. In addition, the legislation includes an exemption of anti-kickback laws that would allow hospitals to provide health care IT hardware and software to individual physicians. The Senate in November 2005 passed a different version of the bill (S 1418) that does not include the provision on billing codes or the exemption of anti-kickback laws (Kaiser Daily Health Policy Report, 9/12). Both chambers have a goal of passing compromise legislation by the end of the week, and negotiations are "progressing," CongressDaily reports.

Physician Reimbursements
Meanwhile, prospects for legislation that would stop scheduled reductions in Medicare reimbursements to physicians appear "less promising," CongressDaily reports (CongressDaily, 9/25). A 5.1% reduction in Medicare physician reimbursements is scheduled to take effect on Jan. 1, 2007. House Ways and Means Subcommittee on Health Chair Nancy Johnson (R-Conn.) last week met with physician groups to discuss a proposal that would include a 1% increase in Medicare reimbursements for all physicians in 2007, with an additional 1.5% increase later in the year for physicians who agree to report health care quality information to the federal government. Senate Finance Committee Chair Chuck Grassley (R-Iowa) and ranking member Max Baucus (D-Mont.) also are working on legislation that would reverse the scheduled reduction (Kaiser Daily Health Policy Report, 9/22). In addition, House Energy and Commerce Committee Chair Joe Barton (R-Texas) has drafted a proposal that would reverse the scheduled cut and include a small payment increase, according to CongressDaily. The committee has a hearing on the issue scheduled for Thursday, "which makes it unlikely there will be any agreement before then," CongressDaily reports (CongressDaily, 9/25). According to the Post, the American Medical Association has been "denied" its goal of convincing lawmakers to pass legislation that would reverse the scheduled reduction. Cecil Wilson, chair of the AMA board of trustees, said, "The frustration is the Congress knows what the problem is." He added that the chance that Congress will reverse the reduction during a lame-duck session after the election "is considerably less" (Washington Post, 9/24).

Broadcast Coverage
NPR's "Morning Edition" on Monday examined possible action on legislation that would reverse the Medicare physician reimbursement reduction. The NPR segment includes comments from Baucus; Paul Ginsberg, president of the Center for Studying Health System Change; Frederick Grover, president of the Society of Thoracic Surgeons; and Steven Nissen, president of the American College of Cardiology (Rovner, "Morning Edition," NPR, 9/25). The complete segment is available online in RealPlayer.


"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . В© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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