White House Threatens Veto Of Medicare Legislation

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Medicare

HHS Secretary Mike Leavitt on Tuesday in a letterto the Senate Finance Committee wrote that White Houseadvisers would recommend a veto of any Medicare legislation that includes cutsto Medicare Advantage plans or changes to the Medicare prescription drugbenefit, CQ Today reports. The centerpiece of the Medicarelegislation is the reversal of a 10% cut to physician fees, which is expectedto cost several billion dollars. The Finance Committee has been draftinglegislation that is expected "to rely heavily on the payments to privateinsurers" to stop the fee cut, according to CQ Today. A draftof the legislation has not been released.

Leavitt wrote that a veto would be recommended for any bill that "resultsin a loss of access to health care services, benefits or choices" in theMA program; "raises taxes ... to fund spending increases"; or altersMedicare's fiscal status by overturning administration regulatory decisions. CommitteeChair Max Baucus (D-Mont.) said, "He knows there's no Medicare bill ifthere's no MA cuts. He knows there's no doctor fix if there's no MA cuts"(Armstrong, CQ Today, 12/4).

Health IT

Leavitt in his letter tothe Finance Committee also requested that any change in physician fee cuts belinked to the adoption of health information technology, TheHillreports. Leavitt wrote that the legislation should "[c]ondition receipt ofa portion of any fee adjustment to adoption of certified electronic healthinformation technology," adding, "Physicians who do not adoptappropriate, available technology should receive a lower payment than those whodo" (Young, The Hill, 12/5).

Leavitt in his blog on Monday wrote that physicians should adoptelectronic prescribing and electronic health records to avoid Medicare feecuts. Leavitt wrote that implementation of health IT that meets HHS standardswould reduce medical costs and errors and be part of a long-term fiscalsolution (Carey, CQ HealthBeat, 12/4).

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Separately, Sens. John Kerry (D-Mass.), Debbie Stabenow (D-Mich.) and JohnEnsign (R-Nev.) on Wednesday are expected to introduce a stand-alone bill thatwould require adoption of e-prescribing for Medicare beneficiaries by 2011, CongressDailyreports. A senate aide said the bill would offer a 1% bonus for everye-prescription written and one-time funding for startup costs. Physicians whodo not adopt the technology by 2011 would face financial penalties, the aidesaid. One- or two-year waivers would be available for physicians who havedifficulty acquiring the technology necessary to write e-prescriptions.

Stabenow said she expects the Congressional Budget Office to find that the mandate would save$5 billion to $15 billion over 10 years. Congress' science adviser found that1.5 million drug errors could be prevented annually by using e-prescribing andthat it could save hospitals $3.5 billion in costs related to medication errors(Edney/Johnson, CongressDaily, 12/5).

Kerry, who sits on the Finance Committee, has said the e-prescribing mandateshould be added to the Medicare bill (The Hill, 12/5).

Mark Up Likely Delayed

Finance Committee memberswant to mark up the Medicare package on Friday but still have "not agreedon the major issues," CongressDaily reports. Baucus mustrelease a bill on Wednesday in order to mark it up on Friday, according tocommittee rules (Johnson, CongressDaily, 12/5). However,Republicans and Democrats cannot agree on whether to halt the fee cut for oneor two years (Johnson, CongressDaily, 12/4). Republicans areconcerned about how a two-year fix would be funded (Johnson, CongressDaily,12/5).

Finance Committee ranking member Chuck Grassley (R-Iowa) on Tuesday said,"Things aren't completely worked out between Republicans and Democrats,and then with the Republican group, there are some points of contention thathave to be worked out" (CongressDaily, 12/4).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation.

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