Medicare Rx Drugs, Medical Privacy to be ‘Front and Center’ After Congressional Recess, CQ’s Carey Says

Health issues including Medicare prescription drugs, provider reimbursement increases and new medical privacy regulations will likely be "front and center" when Congress returns in April from a two-week recess, Congressional Quarterly's Mary Agnes Carey reports in this week's "Congressional Quarterly Audio Report." Carey projects that the House will move before the Senate on the prescription drug issue, with House Ways and Means Health Subcommittee Chair Nancy Johnson (R-Conn.) expected to announce a plan in April and a full House vote possible as early as May. The Senate, however, is a "tougher call": Though Sens. Charles Grassley (R-Iowa) and Jay Rockefeller (D-W.Va.) are likely to unveil prescription drug plans, whether any measure will come to the floor for a vote is uncertain. Designing a prescription drug bill that meets seniors' needs will be "astronomically expensive," Carey notes, adding that many lawmakers may also delay action because they want to add drug coverage as part of a larger Medicare overhaul, something difficult to do "with midterm elections just months away."

Provider Reimbursements
Congress may also act to raise Medicare payments to providers, possibly through a supplemental spending bill, Carey says (Carey, "Congressional Quarterly Audio Report," 3/25). Medicare payments to physicians were cut 5.4% this year under a funding formula that relies on changes to the gross domestic product, and anecdotal evidence suggests the decrease is leading some providers to stop taking new Medicare patients. Meanwhile, hospitals, home health agencies and others also say they need Medicare reimbursement increases (Kaiser Daily Health Policy Report, 3/18). Though Congress would "love" to help, President Bush has told lawmakers that any increase to one provider group must be offset by a decrease to others, and "legislators don't want to have to take such steps." But the supplemental spending bill -- intended primarily to fund the war on terrorism -- could provide a vehicle for lawmakers to attach amendments boosting Medicare spending, Carey says.

Patient Privacy and Rights
Carey also provides an update on patients' rights negotiations between the staffs of President Bush and Sen. Edward Kennedy (D-Mass.). The negotiations appear to be stalled over two issues: how high to cap court settlements and whether patient lawsuits should be heard in state or federal courts. Carey notes that "the closer it gets to the election, the less likely there will be an agreement." Meanwhile, Kennedy on March 22 criticized the administration's proposed changes to Clinton-era medical privacy regulations, which would lift a rule that patients must give written consent before their records could be released (see story 1). Carey reports that there is little Kennedy -- who has said he will hold hearings on the issue -- can do to block the changes from taking effect after a 30-day comment period, though "a loud cry from Capitol Hill could cause the administration to make some changes to its proposal." Carey's full report is available online ("Congressional Quarterly Audio Report," 3/25).