Senate Stalls Medicare Bill; Doctors Face Cut in Fees

Doctors who treat Medicare patients face a 10.6 percent cut in their fees next week because the Senate failed to bring up a bill that would have blocked the cuts.

The Senate voted 58-40 to cut off endless debate and take up the bill, two votes shy of the 60 necessary to end the filibuster.

Without action, doctors will see a cut in their fees, though Senate Majority Leader Harry Reid, D-Nev., left the window slightly ajar to take care of the issue when the Senate gets back from its Independence Day recess on July 14. Presumably, the cuts could be restored then.

Reid chided Republican senators, who had blocked action on the bill that earlier had passed the House by a veto-proof 355-59. In the Senate, nine of 48 Republican senators supported the measure. In the House, 129 Republicans supported the bill.

“We’ll be back, and you’ll have another opportunity to vote for this,” Reid said about the House-passed legislation. “During the next 10 days, think about how you’re going to vote on this next time.”

Reid’s words were a veiled warning to the Republican senators that they would probably hear from their constituents about the issue over the recess when they are in their home states.

David P. Sloane, AARP senior vice president for governmental relations, said the organization is “disappointed” by the Senate vote and said AARP would continue to work with senators to get a bill passed.

“This bill would have improved benefits for prevention, mental health and low-income programs and boosted quality through national e-prescribing,” he said, noting the other aspects of the bill in addition to the doctor’s fees.

President Bush had issued a veto threat over the bill in large part because it also would reduce federal payments to private Medicare Advantage plans. Republican Senators agreed that the reductions were not appropriate and offered a compromise. But emboldened by the overwhelming House vote, Senate Democratic leaders rejected that offer.

Some 600,000 doctors care for Medicare patients. Payment rates are set to drop by 10.6 percent on July 1 as a result of a formula that calls for cuts when spending exceeds established goals. Avoiding the cuts has become an annual event for Congress, but finding the money invariably requires trimming payments to other health care providers.

Democrats this year have focused on taking the money from the Medicare Advantage program, which lets older and disabled people get their health benefits through a private insurer rather than through traditional Medicare.

Democratic lawmakers say the government’s payments to the insurers are overly generous, but the administration and supporters in Congress say they translate into lower monthly premiums for Medicare Advantage participants or extra services such as vision and dental care. Under the bill passed by the House Tuesday, insurers would lose nearly $14 billion over five years.

Democratic senators touted the aspects of the bill that they said would help seniors.

Sen. Debbie Stabenow, D-Mich., said the legislation improves coordination between providers and calls for “parity” for treating mental illnesses—equating them with physical illnesses. “This legislation would provide an additional opportunity for ‘tele-help’ connecting more providers and more facilities and a focus on e-prescribing.”

“There are huge advantages in e-prescribing. And you don’t have to read the physician’s handwriting—I say that lovingly to all my physician friends,” she added.