At National Health Council Meeting, Scully Predicts Limited Medicare Reform This Year, Effort to Reduce Payment for Some Medicare Drugs
Centers for Medicare & Medicaid Services Administrator Thomas Scully predicted Sept. 19 that Congress likely would approve limited Medicare reform legislation this year but would not pass a "broad reform" bill that includes a prescription drug benefit, CongressDaily reports. At a National Health Council meeting, Scully said that lawmakers would likely approve "short-term fixes" to address "immediate problems" with Medicare+Choice. "We are still totally committed to Medicare reform and prescription drugs," Scully said, adding, "If it doesn't happen this fall, we're going to keep plugging away, whether it's October or January." He added that "we're likely to see some money put back into the Medicare+Choice program" before the end of the session (Rovner, CongressDaily, 9/19). He said that Congress may revise the reimbursement formula for Medicare managed care plans to "funnel" additional funding to rural providers and help "shore up" the "ailing" program (Rovner, CongressDaily/AM, 9/20). Scully added that although HMO withdrawals from the program will affect "hundreds of thousands" of Medicare beneficiaries in 2002, the numbers "are less than I had feared" (CongressDaily, 9/19). In addition to Medicare+Choice reform, Scully said that lawmakers may "fine-tune" a Medicare "giveback" bill passed last year and address "contractor reform" to "reduce and make more accountable" private companies that process and pay Medicare claims.
Reimbursement for Oncology Drugs
According to CongressDaily/AM, Congress also may reform the reimbursement system for the limited number of prescription drugs covered by Medicare (CongressDaily/AM, 9/20). Medicare covers drugs administered by doctors, such as chemotherapy and kidney dialysis treatments. Scully said that lawmakers and the Bush administration plan a "big push" to reform the payment system, which would likely reduce reimbursements. Lawmakers have expressed concern that drug companies may "inflate prices" reported to the government to increase Medicare reimbursements to doctors who use their drugs and then sell the medicines to providers at a discount. Pharmaceutical companies and some physicians groups, such as the
American Society of Clinical Oncology, have said that reforms to Medicare's drug reimbursement system would "hurt patients." Scully said, "We're going to help patients by charging reasonable prices. Anytime someone tries to change the system, people say it's going to hurt patients, and that's just irresponsible to say that" (Hallam, Bloomberg, 9/19). In addition, Scully said he hopes that lawmakers will pass legislation to provide the Bush administration with the "legal authority" to implement President Bush's pharmacy discount card program (See story 99) (CongressDaily, 9/19).
'No Money' for Reform?
CongressDaily/AM reports that several House committees have begun "working quietly" on an "immediate," but limited, Medicare reform bill to address "needs that cannot wait until next year." However, reduced budget surplus estimates may "hinder" a Medicare reform bill. "There is no money for FY 2002 or FY 2003," one source said. Lawmakers may move a Medicare bill "on its own" or attach legislation to a larger bill to help federal agencies deal with last week's terrorist attacks, CongressDaily/AM reports (CongressDaily/AM, 9/20).
On the Web
On Sept. 21, the House Energy and Commerce Committee has scheduled a joint hearing of the subcommittee on health and the subcommittee on oversight to discuss Medicare's reimbursement system for currently covered drugs. A HealthCast of this hearing will be available on kaisernetwork.org.
