2009-12-22
The Senate has cleared the second of three
key procedural hurdles on its version of health reform legislation, HR 3590, continuing
the effort to pass the bill by Christmas Eve. Key to passage were negotiations resulting in the Manager’s
Amendment, which provides several revisions that have convinced
the last Democratic hold-outs to vote for the bill. Passage requires 60 votes – all of the
Democrats and none of the Republicans voted for the bill.
The Manager’s Amendment includes several
provisions of interest to hematologists, including:
- An increase in bonus
payments to primary care physicians and general surgeons in medically
under-served areas while not cutting payments to non-primary care physicians.
- The Senate dropped a proposal to allow
people age 55 to 64 to buy in to the Medicare program, which pays lower rates
than private insurance.
- The Senate dropped a physician enrollment
fee from the Senate bill that would have required physicians to pay for
participating in the Medicare and Medicaid programs.
Of continuing concern to physicians is that neither the
Senate bill nor the House
bill
include a fix for cuts in the Medicare physician payment system. However, both Houses and the White House
have voiced commitment to addressing this issue and have passed separate legislation
that will prevent the 21 percent cut in Medicare physician payment originally
scheduled to begin on January 1, 2010.
The Department
of Defense Appropriations bill, which was signed into law
by President Obama on December 21, will maintain current physician payment
through the end of February 2010, when health reform or other legislation to
provide a permanent fix for physician payment will have been developed and
agreed to.
Assuming
that the Senate bill is passed on Christmas Eve, the House-Senate conference
will begin in January. It will require
both Houses to reach compromise on the differences between the two bills.
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