NEW MEDICARE LAW BLOCKS PHYSICIAN PAY CUTS

In a swift rebuke to President Bush, on July 15, 2008, Congress voted overwhelmingly to override his veto of a Medicare bill that would forestall pay cuts to doctors who treat seniors, the disabled, and military personnel.

The House voted 383 to 41 to block the president's veto. An hour later, the Senate voted 70 to 26 to override the veto.

The pay cut to doctors would have taken effect July 15, 2008, and many have said it would force them to stop treating Medicare patients.

The bill, called the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), would halt a scheduled 10.6 percent cut in payments to physicians and instead institute a 1.1 percent payment increase in 2009.

The bill would improve preventive and mental health benefits, increase access to physical, occupational, and speech and language therapy, and increase help for low-income Medicare recipients with their out-of-pocket and prescription drug costs.

• Medicare covers one physical within the first six months of when a person enrolls in Medicare. Starting in January, this period will be extended to twelve months, and the cost of the physical will no longer be applied toward the individual’s deductible. 
• The new law phases down the higher coinsurance rate for mental health services by 2014, and lowers the coinsurance rate to equal that of all other services
• The value of life insurance and in-kind financial support from friends and family –as when a son buys groceries for his mother – will no longer count towards the asset test for Medicare Savings Programs (MSP) and Medicare Part D Low-Income Subsidy (“LIS” or “Extra Help”), making it easier for people to qualify for these programs, which help them pay premiums and cost-sharing. 
• In addition, the bill increases the asset limits for MSP to the full LIS limit, which means that about a half million people will begin receiving assistance in paying health care costs. 
• The Centers for Medicare & Medicaid Services will be required to rein in the exorbitant broker commissions that have fueled aggressive and fraudulent marketing of Medicare private health plans.
• Medicare private health plans will be required to provide care coordination and other services that meet the special needs of the enrollees they are designed to serve.
• All Medicare private health plans will be required to implement programs to improve the quality of care they provide.
• Fewer Medicare private health plans will be exempt from requirements that they have networks that guarantee access to specialists and other local providers.
• Drug Coverage. The elderly will see two new categories of drugs added to their Medicare drug benefit. While the change still five years off, taking effect in 2013, seniors then will have coverage under certain conditions for anxiety and sleep-aid drugs. One category is benzodiazepines, a class of widely used anxiety drugs that include Xanax and Valium. The other category to gain coverage is barbiturates, which are typically prescribed as sleep aids and anti-convulsants. But there’s a catch -- Medicare coverage in these categories will be limited to patients suffering from conditions such as cancer, epilepsy or a chronic mental-health condition. Last year, about 51 million benzodiazepine prescriptions were written in the United States.
• Part D coverage for anticancer drugs will be expanded to encompass more treatments that have been shown in respected medical journals to be effective.

Bush and many Republicans opposed the bill because funds to prevent the cut in doctor payments would come from more than $12 billion in cuts to private insurance companies that offer coverage under the private Medicare Advantage program, including Blue Cross and Blue Shield.

But Democrats depicted Bush as siding with private companies over seniors in his drive to privatize the federal program for seniors and the disabled.

The law also affects the 9.2 million active and retired military personnel and their family members who use the military's Tricare system, because it uses payment rates set by Medicare. 

-Adapted from: “Congress overrides Bush's veto on Medicare bill Move blocks pay cuts to doctors” By Nicole Gaouette, Los Angeles Times, July 16, 2008, retrieved from www.boston.com/news/nation/washington/articles/2008/07/16/congress_overrides_bushs_veto_on_medicare_bill/; “ Congress Overrides Veto of Medicare Bill” MEDICARE WATCH , a biweekly electronic newsletter of the Medicare Rights Center, Vol. 11, No. 15: July 22, 2008 and “ Worth Fighting For” Asclepios, Your Weekly Medicare Consumer Advocacy Update , July 10, 2008 • Volume 8, Issue 28, And “ How New Medicare Changes Impact Elderly” www.caregivershome.com/news/article.cfm?UID=1842

 

07/08