Tuesday, July 15, 2008

Information Alert: Veto Override Vote on H.R. 6331, Medicare Improvements for Patients and Providers Act

Today the House will consider the veto override of H.R. 6331, the Medicare Improvements for Patients and Providers Act.  The bill would fund an 18-month increase in Medicare physician reimbursement rates, along with several enhancements to the traditional Medicare benefit package, largely by reducing outlays and enrollment in privately-run Medicare Advantage plans.

  • In his message to Congress, President Bush said that he vetoed H.R. 6331 because the bill would advance a policy of “taking away from seniors to pay physicians,” is “fiscally irresponsible,” and “would imperil the long-term fiscal soundness of Medicare by using short-term budget gimmicks that do not solve the problem.”
  • H.R. 6331 includes several provisions that will reduce payments to privately-run Medicare Advantage plans by $47.5 billion over eleven years.  Some conservatives may be concerned that these changes would undermine the effectiveness of the Medicare Advantage program, which has grown in popularity among seniors due to the benefit enhancements that private coverage can provide.
  • Because language in H.R. 6331 will lead to a 21% reduction in physician reimbursement levels in 2010—an action which many observers would consider highly unlikely—some conservatives may be concerned that this language is designed to mask the true cost of the reimbursement adjustments included in the bill, creating a budgetary gimmick that future Congresses will feel pressured to remedy.
  • H.R. 6331 would establish a new $19.9 billion Medicare Improvement Fund for the “enhancement” of traditional Medicare.  Some conservatives may consider this account a new “slush fund” that will be used to finance further expansions of government-run health programs, rather than to bolster Medicare’s precarious financial future.
  • H.R. 6331 would authorize the Secretary to utilize Part D claims data from private health plans for any use deemed by the Secretary as relating to the public health, and would further authorize Congressional support agencies to utilize the same data for oversight purposes.  Some conservatives may be concerned that these wide-ranging provisions could lead to the public release of proprietary information and/or patient medical information as part of “fishing expedition” investigations at the behest of Democrats philosophically opposed to having private entities provide coverage to Medicare beneficiaries.
  • H.R. 6331 would delay the first round of competitive bidding for durable medical equipment, and would nullify contracts signed by CMS for the first round of bidding this spring.  Some conservatives may be concerned that the delay contemplated by H.R. 6331 would allow a new Administration to take steps undermining the competitive bidding program through the regulatory process, and/or make the “temporary” delay permanent and abolish competitive bidding outright.