Some House Republicans’ objections to proposed Medicare cuts for hospitals and home healthcare providers have stymied efforts by the GOP leadership to push a prescription-drug bill through the House by Memorial Day, Republican staff members said.
Reductions in Medicare hospital payments and home health reimbursement described in a draft of the GOP plan would save $18.6 billion and $3.7 billion, respectively, over 10 years, according to a Congressional Budget Office report presented to Congress last week. Notes on the CBO report made by an industry source were obtained by Modern Healthcare’s Daily Dose.
The savings from hospitals and home health would help pay for an increase in Medicare physician payments that is estimated to cost $20 billion over the next three years.
The draft bill also includes a prescription-drug benefit for Medicare beneficiaries that would cost $350 billion over 10 years.
Republicans and conservative Democrats have appealed to House Speaker Dennis Hastert (R-Ill.) to eliminate the provider payment reductions from the bill. “It would be very difficult to support any legislation that cuts Medicare payments to hospitals, health systems and continuing-care providers,” 10 Republican House members from New York wrote in an April 22 letter to Hastert.
Some Republicans have complained that provider cuts in the bill drafted by Ways and Means Committee Chairman William Thomas (R-Calif.) would create political problems for them in November’s elections.
“There are a lot of members that feel very uncomfortable about this bill,” one staffer said. “They basically said that they can’t support the package the way it is written.”
House Republican leadership met twice yesterday to try to resolve such concerns, the staffer said.
Among the options being considered is splitting the package into two bills; one for the Medicare prescription-drug benefit and the other for Medicare provider payment changes.
Thomas pledged to get his bill through the House by Memorial Day earlier this month. Last week, Rep. Billy Tauzin (R-La.), chairman of the Energy and Commerce Committee, said that the bill would reach the floor by early June at the latest. Energy and Commerce is developing the bill with Ways and Means.
“The rumors that it is slipping into June are very well founded right now,” another Republican staffer said.
Meanwhile, Thomas asked Appropriations Committee Chair William Young (R-Fla.) to include language in the fiscal 2002 supplemental appropriations bill clarifying that HHS has the legal authority to correct a statistical error in the Medicare physician reimbursement formula.
Such a move could potentially take the pressure off Congress to find a legislative way to increase Medicare physician payments. Doctors endured a 5.4% cut in Medicare payments in 2002 and are scheduled for a 5.7% cut in 2003.
A former Medicare official earlier this week said that HHS’ Centers for Medicare and Medicaid Services has the legal authority to correct errors in the payment formula made in 1998 and 1999, increasing physician payments by $46 billion over 10 years.
Young, however, denied Thomas’ request to include the language in the bill, according to an Appropriations Committee spokesman.
“He is on the ropes right now,” said another Republican staff member of Thomas.
Also, Tauzin is considering adding the clarification to its antiterrorism conference bill, said an Energy and Commerce spokeswoman. The Senate and House will meet for the first time tomorrow morning to discuss the bill.
--with Susanna Duff