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Senate Finance Committee Focuses on Medicare Legislation

Leaders of the Senate Finance Committee are in the early stages of developing Medicare legislation that will see action later this year before Congress completes its 2007 session.

Although the House approved far-reaching Medicare provisions as part of its SCHIP reauthorization bill, the Senate made a decision several months ago to separate Medicare from the debate on children's health care. Now that the SCHIP debate appears to have reached a temporary stalemate, the Finance Committee is weighing decisions about which issues to address in its Medicare bill. It appears that the committee is likely to mark up this Medicare bill during the third or fourth week of October.

A major priority of this legislation will be enactment of Medicare physician payment provisions possibly a two-year "fix" to prevent payment rates from declining in January 2008. Sen. Max Baucus (D-MT), the committee chairperson, is contemplating options for reducing Medicare Advantage funding to, at least partially offset the costs of this legislative package.

At AHIP's Medicare Conference two weeks ago, Shawn Bishop, health policy advisor to Chairman Baucus, identified several other issues that the Finance Committee is likely to address in this legislation: improvements in the marketing of private plans, beneficiary information that provides better comparisons of Medicare Advantage and FFS coverage, Part D provisions addressing the prompt payment of pharmacists and the asset test for low-income subsidies, and comparative effectiveness research. Bishop also suggested that the Senate will take a more deliberate approach than the House to "adjusting" Medicare Advantage payments, rather than simply linking Medicare Advantage payments to FFS costs in every county nationwide.

On the other side of the Capitol, the House is expected to continue to push for enactment of the Medicare provisions in its SCHIP reauthorization bill, H.R. 976, the CHAMP Act. This bill proposes, over five years, $50.1 billion in Medicare Advantage funding cuts and $19.3 billion for a Medicare physician payment "fix." Other provisions of the House bill address Medicare Advantage regulatory/administrative requirements, special needs plans and cost contracts, Medicare Part D, Medigap, and Medicare secondary payer rules.



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