11/2/09
CMS announces physician payment cuts.
The Wall Street Journal (10/31, Favole, subscription required) reported that the Center for Medicare and Medicaid Services announced new rules to cut payments for physicians who use expensive medical-imaging equipment. Under the rules, the use of equipment for MRIs and CT scans to screen for diseases will result in cuts of up to 38 percent for physicians who are paid under the Medicare Physician Fee Schedule.
Bloomberg News (10/31, Nussbaum) reported that CMS also announced a "21.5 percent cut for all physicians" with "lower reimbursements for specialists." The "reductions will be made over four years rather than imposed at once in 2010." According to Allen S. Lichter, chief executive officer of the
American Society of Clinical Oncology, "cancer-care doctors will see a six percent reduction over four years." Meanwhile, Jack Lewin, chief executive officer
American College of Cardiology, noted that "the phase-in means 'a slow death' for heart doctors," adding that most cardiologists will "elect to leave the practice."
Lewin noted that "the rule puts into effect policy proposals that will unacceptably reduce payments for cardiovascular-related services," CQ HealthBeat
(10/31, Reichard, subscription required) reported. Jonathan Blum, director of the CMS Center for Medicare Management, said however, that CMS "is removing drug expenditures from a calculation used to set doctor payment rates, which won't affect 2010 payments but "will have a positive effect on future payment updates." James J. Rohack, president of the American Medical Association, urged Congress to "fix the payment formula once and for all this year."
In a separate article, CQ HealthBeat (10/31, Reichard, subscription required) reported that CMS also announced that "hospital outpatient departments will
receive a 2.1 percent increase in Medicare payments in 2010 unless they failed to report data on the quality of their services," while "ambulatory surgery centers
will see a 1.2 percent inflation update next year."
10/28/09
Democratic moderates appear to balk at Reid's health reform bill.
One day after Senate Majority Leader Harry Reid (D-NV) announced his healthcare overhaul plan, some Senate Democrats appeared uneasy about key provisions regarding the public option. Analysts say the potential defections call into question whether Democrats will be able to defeat an expected GOP filibuster. The Washington Post (10/28, Murray, Montgomery) reports that "lawmakers said that if moderates' concerns do not prevent the Senate bill from advancing next month, the opt-out provision could be ditched on the floor. Some moderate Democrats are more comfortable with the 'trigger' approach that
Sen. Olympia J. Snowe (R-ME) has advocated." Sen. Snowe has already indicated that she will not back Reid's bill.
The New York Times (10/28, A20, Herszenhorn, Pear), meanwhile, reports that while the "continuing apprehension" of some lawmakers "indicated substantial uncertainty," Democrats "expressed growing confidence that a version of the healthcare bill would be adopted," either "with or without a public option."
AFP (10/28) notes that "Reid needs 60 votes to carry a procedural measure to move to the healthcare debate, and then 60 more to end debate and hold a final up-or-down ballot." The AP (10/28, Espo) reports that "Reid is expected eventually to secure all 60 Democratic votes on the critical first test to bring the bill to the Senate floor." However, Democratic "Sens. Ben Nelson of Nebraska, Mary Landrieu of Louisiana, Evan Bayh of Indiana, and Blanche Lincoln of
Arkansas all declined to say on Tuesday how they would vote."
Complicating matters for Reid, McClatchy (10/28, Lightman, Talev) reports, "Sen. Joseph Lieberman (ID-CT)...said he'd back a filibuster to prevent a public option from coming to a final vote." And, "while the Democrats, including Lieberman, are expected to vote with their party leadership at least to allow debate to begin, there are serious questions about whether they'll provide the votes needed to end debate over specific parts of the bill or, in the end, to approve the legislation." That, notes The Hill (10/28, Bolton), "means that as things now stand, Democrats will not have enough votes to pass healthcare reform with a so-called public option unless" Reid "can pick up unexpected GOP votes." USA Today (10/28, Fritze) similarly notes that "without Lieberman, Reid must find support from Republicans, none of whom say they back the idea."
The Los Angeles Times (10/28, Hook, Levey) reports, "A senior Democrat said that there were about 10 Democratic senators whose support had yet to be nailed down." Reid "has been meeting one on one with balky Democrats, and made a plea for party unity at the Democrats' weekly closed-door strategy lunch Tuesday. But so fraught are the politics of the debate, some Democrats emerged from that meeting saying they were not sure they would vote even to bring the bill to the floor, let alone vote for its passage." The Washington Times (10/28, Haberkorn) runs a similar story.
In House, "more liberal" public option under 218 votes. The Hill (10/28, Allen, Soraghan) reports, "House Democratic leaders on Tuesday sought to capture some of the momentum created by the inclusion of a public health insurance option" in the Senate "by locking down as many members as possible on which public option they could support in the House healthcare bill." According to "Democratic leaders...a House bill could be unveiled as early as Wednesday, and go to the floor for a vote next week." But, "the leftward momentum in the Senate doesn't appear to have won the day for the most liberal alternative. After weeks of lobbying by liberals and House Speaker Nancy Pelosi herself, the more liberal, Medicare-based option had a clear majority of House Democrats, but not the 218 needed to pass it." CQ Today (10/28, Epstein, subscription required) also covers the story.
10/27/09
Reid says Senate bill will include public option with state opt-out.
The CBS Evening News (10/26, story 2, 2:15, Cordes) reported, "For months, the public option was declared dead in the Senate," but on Monday, Senate
Majority Leader Harry Reid (D-NV) "announced that the contentious government plan would be the cornerstone of the new Senate healthcare reform bill." Sen. Reid said, "The public option can achieve the goal of bringing meaningful reform to our broken system." NBC Nightly News (10/26, story 5, 1:15, O'Donnell) reported, "Leaders of both parties had predicted that a public option was dead. But tonight it is back, and Senate Majority Leader Harry Reid is taking a risk."
But "for more liberal Democrats, this kind of public option or any kind of public option is considered a victory."
On ABC World News (10/26, story 5, 2:45, Gibson), George Stephanopoulos said Reid "still may not have the votes to get this to the Senate floor. But what the Senate leader saw is that he would have a lot more trouble with the majority of Democrats if he didn't include the public option in the bill than if he did."
USA Today (10/27, Fritze) reports the "latest iteration of the public option would give millions of Americans who are not covered through their employer the option to buy insurance run by the government. States would have until 2014 to decide whether to withdraw from the public program, which Reid says would drive down rates." According to Bloomberg News (10/27, Litvan, Rowley), Reid "said the so-called public option with the opt-out provision is the 'fairest way to go' to ensure competition for private insurers."
The New York Times (10/27, A1, Pear, Herszenhorn) reports in a front page story that Reid "sided with his party's liberals," but the announcement "set the stage for a test of Democratic party unity. With Republicans united for now in opposition to any bill including a public option, Mr. Reid needs support from all members of his caucus -- 58 Democrats and two independents -- to take up the legislation. Aides said Monday that he appeared to be short of that goal, lacking firm commitments from several members of the caucus." The Los Angeles Times (10/27, Levey) reports the "'opt-out' compromise is still two votes shy of the 60 Reid needs to overcome a Republican filibuster, according to a senior Democratic aide on Capitol Hill who requested anonymity when discussing the plan."
AFP (10/27, Knox) says that Reid "said the public option was 'not a silver bullet' but pointed to recent public opinion polls that showed a majority of
Americans support the option to pick a government-backed insurance plan." The Senate debate "on the bill, a compromise between legislation from two Senate committees, will begin as soon as congressional budget analysts formally estimates how much the measure will cost -- most likely later this week -- according to Reid."
The Washington Times (10/27, Haberkorn) reports that Sen. Olympia Snowe (R-ME) "said she was 'deeply disappointed' with Mr. Reid's decision and would not support the bill." The Hill (10/27, Young) likewise reports Reid's decision "could cost him the support of" Sen. Snowe, "the only Republican to support a healthcare bill in Congress this year." With or "without Snowe, Reid said he's going ahead with the opt-out public option, though he voiced hope that Snowe could still be convinced."
The Washington Post (10/27, Murray, Montgomery), McClatchy (10/27, Lightman), the Wall Street Journal (10/27, A1, Hitt, Adamy, subscription required), the Oregonian (10/27, Pope), and Roll Call (10/27, Drucker, subscription required) also cover the story.
Lieberman says he's motivated by deficit, not insurers' interests. The Hill (10/27, Rushing) reports Sen. Joe Lieberman (I-CT), "one of a handful of Senate wild cards in this fall's healthcare reform debate, says his concern about the Senate bill is based on the national deficit -- not the insurers that dominate his state."
Lieberman "told The Hill he may support a bill that taxes insurers or cuts into their profits, but only if the federal deficit won't balloon as a result." Lieberman said, "Insurers aren't my biggest concern -- I sued them once when I was attorney general, and I'm not afraid to end anti-trust exemptions. I am really worried about what this could do to the deficit."