Medicare Vote coming Wednesday

[AngelinaCat]

Hi All:

This came in on my email today and is from the Military Officers Association of America's newletter.

I am copying and pasting as I got it. The adressee's name is blanked. I have not researched on my own; this is for informational purposes only. I do, however, trust the source. Thanks.


Dear Chief Warrant Officer XXXXXXXX,

Senate Medicare/TRICARE Vote Wednesday

A little more than a week ago, Congress failed to pass a Medicare fix (H.R. 6331) by a single vote (59 to 39, when 60 votes were required). This was particularly frustrating since the House previously passed the fix by an overwhelming margin.

As a result, a 10.6% cut in Medicare payments to doctors went into effect July 1.

Medicare has suspended action on claims until July 15 in hopes that a new law preventing the cuts can be passed by then. If that doesn't happen, the cuts will take effect, and many doctors have said they'll stop taking Medicare and TRICARE patients (TRICARE payments are tied to Medicare's).

The Senate has scheduled a new vote on the Medicare bill on Wednesday, July 9. That means we have only 24 hours to generate a wave of grassroots inputs to senators asking them not to fail America's seniors this time.

Please use MOAA's Web site immediately to send your senators a MOAA-suggested message urging them to vote FOR the Medicare fix.

[JRScott]

This makes me wonder how a government health program will cut costs. Obviously the original goal is to cut costs and doctors are refusing to take it, how will a national health care plan be any different I wonder.

I suspect though that even though Doctor's are threatening to do such that they can't afford the lost work, so most would still take Medicare, basically an empty threat.

[WhatMoney]

I expect it will pass today, but Bush has threatened to veto it. The Republicans want to give more Medicare money to the private Medicare insurers than to regular Medicare recipients, in an attempt to sabotage government run Medicare. Only 23% of Medicare recipients are now using private insurance HMO's. This is another example of Bush & the Republicans helping out their wealthy corporate friends at the expense of the the middle class and poor Seniors.

July 8th, 2008
AMA does partisan battle over Medicare cuts

The AMA strives to be non-partisan.

Many doctor-politicians have been Republicans over the years, including former Majority Leader Bill Frist.

But the gloves are off this week, as doctors (and psychiatrists too) seek to pressure Republicans to support the reversal of a cut in Medicare reimbursements which went into effect July 1.

The ads use insurance companies as its bogeymen, and are aimed at getting a cloture vote in the Senate, cutting off debate, passed as early as this week.

But this fight is an uphill climb. President Bush has threatened a veto of the bill, so the docs may need as many as 8 Senators to switch sides in order to pass it. Some 22 Republican Senate seats are up for election this year.

The current bill is only a short-term fix to the problem of Medicare funding formulas, offering a slight hike but leaving intact language calling for cuts later on.

Some doctors are doing more to pile on the pressure, cutting back their patient services and closing their doors to new Medicare patients.

There is also an underlying ideological struggle going on.

Republicans support the privatization of Medicare services through Medicare Advantage plans offered by the insurance industry, and present formulae are geared to supporting them.

Thus HMOs like Coventry Health Care are urging their customers to defy the AMA and their own AARP lobby in order to oppose the bill.

It will be interesting to see the electoral impact if the doctors fail to get Republicans in Congress to do their bidding. Will patients follow their lead and throw the GOP out?
http://healthcare.zdnet.com/?p=1119

[AngelinaCatHub]

We already have Socialized Medicine called Medicare. When you are 65 you MUST use Medicare first. And guess what “Government” is doing. Fussing it around. Using it for a power tool. Wait till we get our FREE medical with Socialized care. If Bam gets in he is inviting all illegal’s to participate as if they have been paying into the system for years like we have. When that happens, best to stay as healthy as possible because you will be in a very long line waiting for that operation. If in Governments determination, you do not meet THEIR requirements such as “too old to save”, better consider prepaid Funeral arrangements. ‘Hub

[WhatMoney]

Bill Passes 69 to 30 Veto Proof Margin

Senate Overwhelmingly Passes Medicare Bill
Kennedy Makes First Hill Appearance Since Surgery

By Paul Kane
Washington Post Staff Writer
Wednesday, July 9, 2008; 5:12 PM

Sen. Edward M. Kennedy (D-Mass.) made a dramatic return to the Capitol today to help the Senate pass legislation that would rescind a sharp cut in Medicare payments to physicians.

Kennedy, who underwent surgery June 2 to remove a life-threatening brain tumor, appeared on the Senate floor at 4:15 p.m. today for the first time in more than six weeks, bringing activity in the chamber to a halt and prompting a standing ovation that lasted several minutes.

The legislation--which fell just one vote shy of passage less than two weeks ago, prompting the call for Kennedy to appear--was approved 69 to 30, a veto-proof margin.

[JRScott]

I am concerned about this, mainly because I see it as an effort by the government to control cost that ultimately failed.

We'll see if Bush vetoes it I guess, not sure he will. Then the question is how many actually vote on it the second time, its pretty close.

[BigJohn]

If Obama gets elected, the Iraq war is suppose to come to an end and the money saved, can be spent in our own care.
My wife comes from a third world country. After 9/11/2001 her country acquired national health insurance. Everybody is covered. The cost: initially it was about 75 cents but they realized the paper work cost more then what was brought in so they changed that to being free. The medical care might not be the best, but at least it is medical care. If a person can afford it, they can still go to a hospital that takes insurance or cash.

[WhatMoney]

The 69-30 roll call by which the Senate approved a bill on Wednesday that would void a 10.6 percent pay cut for doctors treating Medicare patients.

Voting "yes" were 49 Democrats, 18 Republicans and two independents.

Voting "no" were 0 Democrats and 30 Republicans.

Here are all the Republican senators that voted against the bill. These guys are the enemy - remember them on election day. (Asterick means they are up for re-election in 2008):

Alabama
Sessions* (R) No; Shelby (R) No.

Arizona
Kyl (R) No; McCain (R) Not Voting

Colorado
Allard* (R) No

Idaho
Craig* (R) No; Crapo (R) No.

Indiana
Lugar (R) No.

Iowa
Grassley (R) No;

Kansas
Brownback (R) No

Kentucky
Bunning (R) No; McConnell* (R) No.

Louisiana
Vitter (R) No.

Mississippi
Cochran* (R) No; Wicker (R) No.

Missouri
Bond (R) No

Nebraska
Hagel* (R) No

Nevada
Ensign (R) No

New Hampshire
Gregg (R) No; Sununu* (R) No.

New Mexico
Domenici* (R) No.

North Carolina
Burr (R) No

Oklahoma
Coburn (R) No; Inhofe* (R) No.

South Carolina
DeMint (R) No; Graham* (R) No.

South Dakota
Thune (R) No.

Utah
Bennett (R) No; Hatch (R) No.

Wyoming
Barrasso (R) No; Enzi* (R) No.

[JRScott]

If Obama gets elected, the Iraq war is suppose to come to an end and the money saved, can be spent in our own care.
My wife comes from a third world country. After 9/11/2001 her country acquired national health insurance. Everybody is covered. The cost: initially it was about 75 cents but they realized the paper work cost more then what was brought in so they changed that to being free. The medical care might not be the best, but at least it is medical care. If a person can afford it, they can still go to a hospital that takes insurance or cash.

BigJohn ending Iraq and Afghanistan will not save money. It has never been part of the budget and has always been financed by deficit spending. Every dollar spent on them has gone to the national debt. All ending them will do is stop running up the debt (which we need to do).

[WhatMoney]

WASHINGTON -- In a floor session electrified by the appearance of Sen. Edward M. Kennedy, the critically ill Massachusetts Democrat, the Senate voted Wednesday to stave off a cut in Medicare fees to doctors who treat seniors, military personnel and their families and others.

Kennedy, a longtime champion of the federal Medicare program who underwent surgery for brain cancer last month, appeared halfway through the vote, to tears and thunderous applause from fellow senators and spectators.

Moving carefully but steadily, his broad face slightly puffy, Kennedy held up both thumbs, flashed a smile and roared his vote: "Aye."

Democrats credited Kennedy's appearance with their 69-30 victory in what had been a closely contested and bitterly partisan dispute. A Senate vote on an identical measure failed by one vote in June.

"We got this victory because of Ted," said Sen. Max Baucus (D-Mont.), chairman of the Senate Finance Committee. "He made this happen."

The vote, coming on what Democrats had cast as a key election year test, sets the stage for a showdown with President Bush, who has promised to veto the bill. But Senate leaders, buoyed by their victory, sounded confident. The bill has already passed the House by a veto-proof 355-59 vote.

"Let the president veto it," said Senate Majority Leader Harry Reid (D-Nev.). "We got overwhelming support in the House and more than enough votes to override a veto today."

In an added element of drama, the only senator to miss the vote was Sen. John McCain (R-Ariz.), his party's presumed presidential nominee, who was campaigning in Ohio. McCain would have faced the choice of voting against the interests of seniors and active and retired military personnel, whose healthcare system is linked to Medicare, or voting against party elders at a time when he needs their support.
McCain also was absent for the June vote, in which the measure ultimately failed 58 to 40. Between the votes, nine Republicans switched sides, with 18 Republicans voting in favor overall. McCain said in a statement later Wednesday that he would have opposed the measure. Sen. Barack Obama, the Illinois Democrat and presidential candidate who accompanied Kennedy onto the Senate floor, supported the bill.

The Medicare Improvements for Patients and Providers Act of 2008 would halt a 10.6% cut in payments to physicians, scheduled to take effect July 15, and instead institute a 1.1% payment increase in 2009. The bill would also boost preventive and mental health benefits.

Bush and many Republicans opposed the bill because the funds to prevent Medicare reimbursement cuts would come from more than $12 billion set aside to pay private insurance companies that offer Medicare Advantage, including Blue Cross, Blue Shield and Humana.
The American Medical Assn. estimates that without the legislation, 60% of U.S. doctors will be forced to limit the number of new Medicare patients they treat.

Groups representing military personnel say the cut would particularly hurt the 9.2 million active and retired personnel and their family members in the military's Tricare system, which uses payment rates set by Medicare.

The annual cuts in Medicare reimbursement rates for doctors stem from 1990s legislation intended to lower the federal deficit. The Medicare reductions were supposed to occur in small increments every year, but Congress has generally canceled them. The result is that the small cuts have become cumulative -- now totaling over 10% -- but Congress has not rewritten or repealed the requirement for the cuts.

Though both sides agree that the cuts in Medicare reimbursements should be prevented, they do not agree on how.

Insurance firms and Republicans say the cuts in Wednesday's bill would lead to benefit reductions for seniors who rely on the private Medicare Advantage program -- about 20% of the nation's 44 million Medicare beneficiaries.

Medical groups countered that the cuts to private companies would largely eliminate waste because private insurers charge the government, on average, 12% to 17% more than the Medicare program charges.

"If they cut services to seniors, it's because they choose to, rather than cut advertising or profits," said Maria Freese of the National Committee to Preserve Social Security and Medicare.

Medical groups, which had lobbied hard for the bill, celebrated its passage.

Doctors welcomed Wednesday's vote as a small reprieve from financial pressures that were leading many of them to limit or even stop seeing Medicare patients. They warned, however, that the bill was a short-term fix.

"It doesn't solve the longer-term problem," said Dr. Howard R. Krauss, president of the Los Angeles County Medical Assn., who said that financial pressures were already pushing some Los Angeles doctors to limit the number of Medicare patients they treat, or to end their Medicare practice altogether. "There needs to be an overhaul of our health system nationally so that there's adequate healthcare for everyone."

Kennedy, 76, flew directly to Washington after his daily cancer treatment and returned to Massachusetts immediately after the vote. His wife, Victoria Reggie Kennedy, wiped away tears as she watched from the Senate press gallery, where she sat with her niece Caroline Kennedy.

"I return to the Senate today to keep a promise to our senior citizens -- and that's to protect Medicare," Kennedy said later in a statement. "Win, lose or draw, I wanted to be here. I wasn't going to take the chance that my vote could make the difference."

nicole gaouette
latimes.com

[WhatMoney]

H.R. 6331 is finally law

H.R. 6331, the "Medicare Improvement for Patients and Providers Act of 2008"

Latest Update: Both the Senate and the House of Representatives voted on Tuesday, July 15, 2008, to override the presidential veto of H.R. 6331, the Medicare Improvements for Patients and Providers Act of 2008, making this Bill a law.

With great political drama, the Senate on July 9, 2008, passed H.R. 6331, the "Medicare Improvement for Patients and Providers Act of 2008," by a vote of 69 to 30[i]Bush vetoed it as expected.]

Most press reports describe H.R. 6331 as a bill that cancels the pay cuts to doctors that went into effect on July 1, but the bill also contains improvements for Medicare beneficiaries. While these improvements are much more modest than the improvements included in legislation passed by the House of Representatives last year, they are still significant and will provide relief to many older people and people with disabilities.

The Political Process

H.R. 6331, as all Medicare legislation during the 110th Congress, has been mired in the political debate concerning treatment of Medicare Advantage plans. Although provisions to fix the looming cut in Medicare payments to doctors enjoyed bi-partisan support, the White House has threatened to veto any legislation that makes what it has called significant changes to Medicare Advantage plans. Despite that comment, the vote by the House of Representative indicates that H.R. 6331 may have sufficient support in the House to override a presidential veto.

Senate procedural politics affected the Senate vote.[ii] Most simply, the vote on H.R. 6331 was technically a vote to invoke "cloture," which is a vote to limit the time spent debating the bill, that is, to avoid a filibuster.. A vote to invoke cloture requires 60 votes. Thus, even though a majority of Senators voted for H.R. 6331 when it was brought to the floor on June 26th, there were insufficient votes (58)[iii] to invoke cloture and to allow the Senate to vote on the bill itself. Senator Kennedy (D. Mass.) returned to the Senate for the July 9th vote on H.R. 6331 to ensure that the bill would receive the necessary 60 votes. After the 60 votes were reached, additional Senators voted in favor of the bill. When the bill passed, the Senate proceeded by "unanimous consent" to approve the legislation. The cloture vote, 69-30, indicates that there also may be sufficient support in the Senate to override a presidential veto.

A Summary of Provisions in H.R. 6331 Relevant to Medicare Beneficiaries

As indicated, H.R. 6331 contains a number of provisions that make improvements for Medicare beneficiaries. The Center will issue an Alert that discusses the provisions in more detail if and when H.R. 6331 is enacted into law.

Relevant sections provide:

1. Provisions for Low-Income Individuals

QI program: Extends the QI program through December 31, 2009, and increases funding for the program.

Low-income subsidy (LIS) and Medicare Savings Program (MSP): Effective 2010, increases the assets test for MSP to the LIS asset level for full subsidy individuals. This change includes indexing the MSP asset test for the first time since the program was authorized in 1986.

MSP applications: SSA is directed to provide LIS applications and information about MSPs to individuals potentially eligible for such subsidies, to provide assistance with applications, and to share LIS application information with states such that the receipt by the state of such information initiates an application for MSP.

Out -of -pocket expenses: Limits cost-sharing for beneficiaries who are dually eligible for Medicare and Medicaid and who enroll in Special Needs Plans to the cost-sharing under Medicaid.

Late enrollment penalty: Eliminates the Part D late enrollment penalty for LIS-eligible individuals.

Eliminates estate recovery: Eliminates the authority for states to collect from estates of deceased beneficiaries the amounts paid to MSP recipients.

Changes to definitions of income and resources for LIS: Exempts value of life insurance policy (resources) and in-kind support and maintenance (income).

Judicial review of LIS decisions: Provides for a right to federal court review

Translation of model form: The model MSP application must be translated into languages most frequently used by Medicare beneficiaries and made available to states.

Assistance to SHIPs and Area Agencies on Aging: Provides additional funding, some of which is targeted to LIS outreach.

2. Part A and Part B Provisions:

Extension of exceptions process for therapy caps: The process is extended until December 31, 2009.

Durable medical equipment, prosthetics, orthotics and supplies (DMEPOS): Delays for 18 months implementation of the competitive bidding acquisition process for DMEPOS, which went into effect in 10 areas on July 1, and modifies the competitive bidding process.

Improvements to preventive services: The Secretary can use the national coverage determination process to add coverage of new preventive services. The "Welcome to Medicare" physical is extended from 6 months to 1 year, and the deductible does not apply.

Mental health services: Decreases over 6 years the coinsurance for mental health services to the 20% coinsurance rate for other Medicare services.

Chronic obstructive pulmonary disease and other conditions: Includes coverage of intensive cardiac rehabilitation programs and repeals transfer of ownership of oxygen equipment

Medigap: Requires implementation of modifications made by NAIC to the standard Medigap plans. The modifications contain restructuring of current benefit packages.

3. Part C and Part D Provisions:

Prohibitions and limitations on marketing of Medicare Advantage (MA) and prescription drug (PDP) plans: Prohibits door-to-door sales, cold calling, cross selling of non-health-related products. Requires limitations on commissions and gifts, and requires agents to abide by state appointment laws. Some provisions would be effective in time for the 2008 Annual Enrollment Period.

Phase-out of indirect medical education (IME): Phases out an adjustment to MA payment rates for IME, but continues to pay teaching hospitals directly for their higher patient care costs.

NOTE: This provision is the only adjustment to Medicare Advantage payment rates. It adopts a recommendation of the Medicare Advisory Payment Committee (MedPAC) to eliminate these duplicate payments.

Private Fee-for-Services (PFFS) changes: Requires PFFS plans in counties where there are two HMOs or PPOs to form networks of providers, beginning in 2011. Also requires PFFS plans, effective 2010, to have the same quality improvement programs as local PPOs.

Special Needs Plans (SNPs): Extends the authority of SNPs and the moratorium on new SNPs through December 31, 2010. Includes new eligibility and care management requirements and quality reporting standards.

Coverage of barbiturates and benzodiazepines: Permits coverage under Part D of barbiturates (for certain conditions) and benzodiazepines, effective January 1, 2012.

Protected classes of drugs: Codifies current guidance concerning coverage of "protected classes" of drugs under Part D and authorizes modification of the protected classes through rulemaking.

Medically accepted indication for drugs: Authorizes Medicare to revise the compendia used for identifying medically accepted indication for Part D drugs, and provides that the criteria for anticancer drugs covered under Part D should be the same as the criteria for anticancer drugs covered under Part B.

The Center for Medicare Advocacy will continue to provide updates about the future of H.R. 6331.

[i] Senator McCain was not present for the vote.
[ii] The Senate Glossary defines many of the terms used to discuss pending legislation and Senate procedures. http://www.senate.gov/pagelayout/ref...s/glossary.htm
[iii] Senate Majority Leader Reid (D. Nev.) changed his vote from yes to no in order to be able to ask that the Senate reconsider the cloture vote on H.R. 6331.

July 10, 2008 Center for Medicare Advocacy, Inc.

[Bandit]

I saw that & was pleased. It is about time they sit bush down on his head & look after the elderly & afflicted.