Sen. Chuck Grassley (R-Iowa), ranking member of the Senate Finance Committee, upped the ante for Medicare legislation with a bill that would give physicians a 0.5% pay increase through 2008. The increase would more than double in 2009 and beyond.
Grassley told reporters he wouldnt officially release his alternative for Medicare reform until Sen. Max Baucus (D-Mont.), the committee chairman, introduces his own bill, which Baucus staff says may be released Friday or Monday.
The pay increase in Grassleys draft bill is more than what Democratic leaders have proposed and forces a surprisingly public showdown between Grassley and Baucustwo senators with a reputation for cooperating well in public and private. Baucus on Monday said he would draft a bill that freezes physician payments through 2008, with an increase of 0.5% in 2009.
Under Grassleys legislation, providers who use a qualified electronic-prescribing system would be eligible for bonus payments from 2009 through 2013, while hitting those physicians who dont use an e-prescribing system with payment reductions of up to minus 0.2%, starting in 2011 through 2013all of which are in line with the Democrats' legislative blueprint.
Other provisions are also similar, including one that would extend the Physician Quality Reporting Initiative through 2010 and another requiring HHS to develop a value-based purchasing plan for providers.
Both lawmakers would help pay for the legislation by tapping funds from the Physician Assistance and Quality Initiative Fund. But its unclear how Grassley wants to pay for the bulk of the bill. Baucus has said that he would use offsetting dollars from private Medicare plans despite a veto threat from the White House.
Finance Committee member Sen. Kent Conrad (D-N.D.) seems optimistic that a bipartisan solution could still be reached. There has been jousting among the members, but I think well find a way to get together and get this thing done, Conrad told reporters, following a meeting of the finance panel. -- by Matthew DoBias and Jennifer Lubell