CONGRESS PASSES MEDICARE BILL!

 On Nov. 25, Congress passed the Medicare prescription drug bill. Accepted in the House on Nov. 22, the Senate sealed the deal by voting in favor of the bill Tuesday morning, following a marathon weekend debate. Blocking a 4.5 percent cut in physician payment was one of many AMC/NOMA objectives that were accomplished with passage of the Medicare prescription drug bill. The legislation also increases payments for physicians in rural and underserved areas, gives physicians due process protections for Medicare carrier audits and preserves the current physician coding system.

Physician leaders and lobbyists worked closely with the House and Senate Republican leadership and Bush Administration officials to help generate winning margins on some difficult votes en route to final passage. Another critical factor was the intense response from physician members of the AMC/NOMA. Capitol Hill was inundated with tens of thousands of physician phone calls, faxes and e-mails responding to the Call to Action. This bill will avert a Medicare patient access meltdown.

Key provisions include:

• Physician update: Replacing a 4.5 percent cut with a 1.5 percent increase represents a 6 percent favorable swing in the Medicare conversion factor. Additional cuts in 2005 will also be prevented. Prescription drug benefit: Prescription drug benefit is consistent with AMA principles and targets financial assistance to neediest patients.
• Regulatory relief provisions: Due process protections for Medicare carrier audits include deferring any financial penalties until physician appeal rights are exhausted, no penalties when a physician relies on guidance from Medicare officials, an opportunity to correct errors before repayment demands are made and limits on extrapolation or small-scale audits to generate large overpayment demands.
• Physicians in rural and underserved areas: Geographic payment disparities would be reduced with a $1 billion increase in the work component to the fee schedule; an additional $700 million in incentives to maintain and enhance the physician supply in rural and underserved areas.
• Medical savings accounts: Increased tax benefits are provided to patients of all ages that enroll in medical savings accounts (now known as Health Savings Accounts)
• Electronic prescribing: voluntary instead of mandatory
• CPT coding: Physicians can continue to use their current coding system, preventing a move from some 7,000 codes to 170,000 used in ICD 10