Healthcare Business News

House measure seeks remove fix to doc-fee formula

By Jennifer Lubell
Posted: October 13, 2009 - 4:30 pm ET

House Democrats have made further adjustments to their sweeping healthcare legislation, adding a measure that would expand coverage for young adults while taking steps to remove an expensive “fix” to Medicare's physician payment formula.

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At a news conference, House Speaker Nancy Pelosi (D-Calif.) announced the addition of a new provision that would enable young adults between the ages of 19 and 26 to remain under their parent's healthcare coverage.

About 31% of young adults do not have insurance, making them the most uninsured population in the country, said Rep. Kathy Dahlkemper (D-Pa.), who has advocated for such a coverage expansion. Doing so, she said, will drive down health insurance premiums “by adding lower risk individuals to the health insurance pool.”

The exact cost savings of this measure “is being teased out” by the Congressional Budget Office, said Rep. Chris Van Hollen (D-Md.) during the news conference.

Van Hollen, who sits on the influential House Ways and Means Committee, confirmed earlier news reports that a provision to fix Medicare's physician-fee-schedule formula would be moved out of the healthcare reform bill, and addressed as part of a separate bill. The provision, which among other things would have prevented physicians from experiencing a 21% pay cut next year, would have cost $240 billion over the next decade.

J. James Rohack, president of the American Medical Association, seemed hopeful that Congress would address the payment fix issue in some form this year.

“We understand that House leadership remains committed to permanent repeal of the broken Medicare physician-payment formula that hurts seniors' access and choice of physicians. This is an essential element of health reform to preserve the security and stability of Medicare,” Rohack said in an e-mail.

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