June 2008 Practice Update (part two)

Medicare Physician Payment Fix – Senate Plans to Vote before July 4 Recess
As this article goes to press, the Senate plans to vote on Medicare legislation H.R. 6331 (the "Medicare Improvements for Patients and Providers Act of 2008") before the July 4 recess. Senate Majority Leader Harry Reid (D-NV) is determined to vote on this bill, and voting could occur as soon as Friday or possibly over the weekend. The bill would halt the 10.6 percent Medicare physician payment cut scheduled to take effect July 1, 2008, by extending the current 0.5 percent update through the end of 2008 and implementing a 1.1 percent update for 2009.

However, there may be strong opposition preventing passage or even a vote on this bill. There is bipartisan agreement and a sense of urgency that a Medicare physician payment cut needs to be averted. The dispute is over funding for the fix, with strong presidential and Republican opposition to using monies cut from Medicare Advantage plans.

The pending bill is very similar to S. 3101, a bill which Senate Finance Committee Chair, Max Baucus (D-MT), introduced last week. Senator Baucus is very supportive of H.R. 6331, which passed the House of Representatives by a wide bipartisan margin on June 25, putting increased pressure on the Senate to take action. Insight on the differences between the Senate and House bills is available on the ASH Web site.

Outlook: There is a good chance the Senate will pass a Medicare physician fix by the July 1 deadline. If this does not occur, the legislation will not move forward until after the July 4 holiday. It is important to note that even if the bill is passed before July 1, physicians should anticipate some delay in CMS implementation of the payment fix. ASH will continue to keep its members apprised of all developments concerning this important issue.

Health Information Technology Legislation Introduced in the House
House Committee on Energy and Commerce Chairman John Dingell (D-MI) and Ranking Member Joe Barton (R-TX) have introduced legislation (H.R. 6357) designed to promote the nationwide adoption of electronic health records. Among other steps, the bill directs the Department of Health and Human Services to create several bodies that will set national standards and assist in the process of Health Information Technology Legislation (HIT) adoption. The bill also makes several grants and loans available to incentivize HIT use by private health-care providers. In addition, the legislation creates a regulatory framework to address privacy concerns.

Medicare Part B Drug and Biological Average Sales Price Payment Amounts Now Available
The Centers for Medicare & Medicaid Services (CMS) has made available online the Medicare Part B Drug and Biological Average Sales Price (ASP) Payment Amounts for July 1, 2008, to September 30, 2008.

PQRI Update: 2007 Confidential Reports, Payment Available in July
CMS will make confidential feedback reports for all practices that participated in the 2007 Physician Quality Reporting Initiative (PQRI) available online beginning on July 10, 2008. Reports will include:

• Tax Identifier Number (TIN)-level reporting and financial information
• Individual-Professional-level Reporting and Performance Information
• National-average performance comparison information

On July 14, 2008, CMS will begin sending incentive payments for satisfactory reporting to all participants in 2007 PQRI. Payments will be made at the TIN level.

For more information on PQRI, visit the CMS Web site or the Resources for Practitioners section of the ASH Web site.

Have a Pressing Clinical Question?
Consult a Colleague is a service for ASH members designed to help facilitate the exchange of information between hematologists in practice. Clinical questions in the areas of hemostasis/thrombosis and lymphoproliferative disorders may be submitted online and will be answered by your colleagues in the field in one to two business days. In the future, the program may be expanded to include other clinical areas as well.

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