Senate Finance Committee Democrats Working To Finalize Medicare Package

Democrats on the Senate Finance Committee are completing work on a $45 billion package that would boost payments to Medicare providers, CongressDaily/AM reports. The package is expected to update payments for physicians, hospitals, nursing homes and managed care organizations. The proposal will reportedly include a provision authorizing competitive bidding for durable medical equipment, but likely will not include coverage for oral cancer drugs or self-injected medications, as previously considered (CongressDaily/AM, 9/24). Several senators, including Labor-HHS Appropriations Subcommittee Chair Tom Harkin (D-Iowa), also are pushing to raise reimbursements for rural hospitals. However, the prospects of reaching a compromise on the legislation are getting "dimmer," congressional aides say (CongressDaily, 9/23). The Bush administration believes the cost of the package is too high and instead favors a bill costing less than $20 billion over 10 years, according to an administration source (Bennett/Marre, InsideHealthPolicy.com, 9/23). The administration also supports a package that would direct funding increases toward physicians and Medicare+Choice plans. Potentially complicating the debate, Sen. Olympia Snowe (R-Maine) has pledged to offer a prescription drug benefit amendment to any bill for health care providers (CongressDaily, 9/23). It is unclear whether the Senate package will go through committee or directly to the floor (InsideHealthPolicy.com, 9/23). Meanwhile, a House Medicare "giveback" package (HR 4954) that was approved in June is "getting another look to see if it can be trimmed," CongressDaily reports (CongressDaily, 9/23). That legislation, which also included a Medicare drug benefit, would provide approximately $14 billion to hospitals, including $9 billion to rural facilities over 10 years, and would reverse scheduled cuts in payments to physicians and home health care providers. In addition, it would allocate $3 billion to insurers that offer Medicare+Choice plans. The House package would allocate about $30 billion overall for hospitals, physicians and other providers (Kaiser Daily Health Policy Report, 9/13).