BREAKING NEWS ON MEDICARE LEGISLATION: NOT OVER YET

As you most likely know by now, yesterday the House of Representatives voted overwhelmingly in favor (355-59) of Medicare legislation that would avert a 10.6% cut in Medicare physician services payments. This bill (H.R. 6331) is referred to as the Baucus Bill because it is the legislation that Senate Finance Chairman Baucus attempted to pass last week in the Senate but did not have the 60 votes needed to close off endless debate (i.e., invoke cloture).

Unfortunately, as of now, it appears that this lopsided vote is a bit misleading. It is unclear this morning if the Senate will even vote on the bill that the House passed or, if it does vote, if it has the 60 votes to pass on the Senate floor or the 67 votes needed to overcome a presidential veto. This is because the bill that passed the House contains cuts to Medicare Advantage fee-for-service, which the President is opposed to and has threatened to veto any bill containing these cuts. It will be difficult for enough Senate Republicans to vote for the House-passed bill that cuts Medicare Advantage if it even comes to the Senate floor for a vote. So many House Members voted for the bill because even those opposed to the Medicare Advantage cuts in the bill knew that the bill would not likely pass in the Senate or even come up for a vote. As we have said before, most Members do not want Medicare payments to be cut 10.6% in this politically charged year.

As the House was taking action on H.R. 6331, Chairman Baucus and Senate Finance Ranking Member Grassley were working on a compromise Medicare bill. It appears that this bill would be an 18-month patch as well, but would only freeze Medicare payments in 2009, which would apparently be an effective 0.5% cut from 2008 levels. This bill would not cut Medicare Advantage fee-for-service plans.

So, the Senate is faced with the dilemma of what bill to take up and when, with time in short supply. Because of this, there is talk that the House is considering passing a 30-day extension to the current Medicare bill, which would give Congress till after the July 4th break to come back and fix this critical situation facing practices and their Medicare patients.