Medicare

Rep. George Nethercutt (R-WA) has enlisted the support of eight House colleagues in an effort to urge House Medicare conferees to abandon their proposal to purchase durable medical equipment (DME) through competitive bidding or at a minimum include a special carve-out for diabetes monitoring equipment.

A Sept. 23 letter asks conferees to give "every consideration to the Senate language, which would freeze DME payments at the current levels."

Clinical laboratories are seeking to quash a proposal in the Senate Medicare bill to impose new beneficiary cost sharing for laboratory tests, arguing labs would face high administrative costs collecting relatively minor payments and likely would have to absorb a substantial portion of unpaid bills.

The industry is seeking to wean Senate conferees away from the $18.6 billion savings generated by the proposal with arguments the proposal is unworkable. The labs have already received a positive response from some Senate Medicare conferees.

President Bush has called House and Senate Medicare conferees to a White House meeting scheduled for 2:30 p.m. today (Sept.25), according to congressional sources. The scheduled meeting appears to fulfill calls from congressional leaders for a push by the president to bring contentious conference negotiations on the rival prescription drug bills to a successful conclusion.

The Medicare conference will not reach an early agreement on provider issues, Ways and Means Committee Chairman Bill Thomas (R-CA) told Inside CMS after President Bush called the conferees to the White House today (Sept. 25) to urge them towards a successful conclusion to negotiations on a prescription drug bill.

"It's got too many facets to deal with in a finite way," Thomas said, noting that payments to insurers were in the mix of provider issues along with hospital and physician reimbursement. "That's part of the mix going forward."

A group of Senate lawmakers are poised to press Senate leaders to strengthen the chamber's language on Medicare's cost contracting program.

Medicare cost contract plans -- HMOs reimbursed for the actual cost of care -- serve roughly 340,000 Medicare beneficiaries and are slated to expire at the end of next year. The Senate bill would extend the program through 2009 and apply Medicare+Choice (M+C) standards and protections to the cost contract program.

Medicare conferees are heading towards a compromise on specialty hospitals that stops short of the Senate bill's ban on physicians referring patients to new, so-called boutiques hospitals in which they have ownership stakes but goes beyond the House bill's call for further study of the issue, Sen. John Breaux (D-LA) told reporters today (Sept. 16).

Breaux, the author of the ban on physician self-referral, said he would accept a modification of his proposal but indicated some of it would survive conference.

As doubt over final passage of a Medicare prescription drug benefit percolates, advocacy groups pushing hard for drug coverage have upped the ante through vocal lobbying campaigns pressing Congress for action.

AARP members descended on Washington, DC last week to pressure Congress to "keep its promise," "finish the job" and "fix and pass" the benefit. The scene was played out at two similar AARP rallies across the country.

More than 100 House members this week urged their chamber's Medicare conferees to drop the House bill's cut to the hospital market basket update, emphasizing that the provision will undermine the payment boost for rural hospitals that was crucial in securing the one-vote victory margin for the chamber's Medicare prescription drug legislation.

House Ways and Means Committee Chairman Bill Thomas (R-CA) this week backed off plans to hold controversial votes on key ideological principles dividing the two chambers' Medicare bills, but still faced renewed partisan tension over looming decisions on the private sector role in delivering Medicare benefits and Democrats' role in the negotiations.

Thomas told reporters after the conference he has no plans to hold votes on principles but will put controversial provider issues to a vote.