amednews: Medicare premium protection bill stalls in Senate

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By Chris Silva

A key lawmaker blasted Senate Republicans for blocking legislation designed to keep Medicare outpatient premiums from going up for seniors next year.

Senate Finance Committee Chair Max Baucus (D, Mont.) had sought unanimous consent to pass the Medicare Premium Fairness Act, which would freeze Medicare Part B premiums at the current rate rather than allowing them to go up by as much as 20% under current law. The House on Sept. 24 passed the legislation by a vote of 406-18. It was introduced by House Energy and Commerce Committee Chair Henry Waxman (D, Calif.) and Rep. Dina Titus (D, Nev.).

According to Baucus' office, Sen. Tom Coburn, MD (R, Okla.), objected to the unanimous consent request, which would have approved the measure without debate or a recorded vote.
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Can Cutting Off Wealthy Seniors Save Medicare?

Passed House: HR 3631 Medicare Premium Fairness Act

Passed House 406-18, 8 not voting with Bipartisan support.
Roll Call

Medicare Part B Premiums for 2010 - Health Blog - WSJ

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By Jacob Goldstein

Shocker: A Medicare bill just passed the House with strong support from both Democrats and Republicans.

Or maybe not so much: The bill isn’t part of the big health overhaul plans getting thrashed out this year. And it’s something likely to be widely popular among seniors, who do tend to vote in disproportionate numbers. But still.

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Examining Sources of Coverage Among Medicare Beneficiaries: Supplemental Insurance, Medicare Advantage, and Prescription Drug Coverage -- Findings from the Medicare Current Beneficiary Survey, 2006 - Kaiser Family Foundation

This updated chartpack presents sources of supplemental and prescription drug coverage among Medicare beneficiaries in 2007, the most recent year for which national data are available. The chartpack looks at variations in supplemental and prescription drug coverage by income, race/ethnicity, age, urban/rural location, and health status. It also examines characteristics of Medicare beneficiaries with low incomes who are not enrolled in a Part D plan or receiving Part D low-income subsidies. Prepared by Kaiser Family Foundation researchers, the chartpack is based on analysis of the 2007 Medicare Current Beneficiary Survey. Download Chartpack

AMNews: July 13, 2009. Part B drug proposal would curtail Medicare pay cuts after 2010 ... American Medical News

The typically bleak outlook that marks the proposed Medicare fee schedule for the upcoming year was significantly brighter this time around for physicians looking for relief from impending pay cuts. In a major policy reversal from the previous administration, the Centers for Medicare & Medicaid Services has proposed removing physician-administered drugs from the calculation of the Medicare physician payment formula. Doctor pay is reduced across the board when spending on all physician services -- a category that includes Part B drugs -- exceeds annual targets. Removing the costs of the drugs would lessen the extent to which spending would exceed targets and trigger cuts. AMNews: July 13, 2009. Part B drug proposal would curtail Medicare pay cuts after 2010 ... American Medical News

CMS Information Collection Activities: Proposed Collection

Revision of a currently approved collection - Manufacturer Submission of Average Sales Price (ASP) data for Medicare Part B Drugs and Biologicals Section 1847A of the Social Security Act requires that the Medicare Part B payment amounts for covered drugs and biologicals not paid on a cost or prospective payment basis be based upon manufacturers' average sales price data submitted to CMS. CMS will utilize the ASP data to determine the Medicare Part B drug payment amounts.

Medicare Program Final Rule

This final rule with comment period implements changes to the physician fee schedule and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. It also finalizes the calendar year (CY) 2008 interim relative value units (RVUs) and issues interim RVUs for new and revised codes for CY 2009. In addition, as required by the statute, it announces that the physician fee schedule update is 1.1 percent for CY 2009, the preliminary estimate for the sustainable growth rate for CY 2009 is 7.4 percent, and the conversion factor (CF) for CY 2009 is $36.0666. This final rule with comment period also implements or discusses certain provisions of the
Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).

DATES:
Effective Date: This final rule with comment period is effective on January 1, 2009 except for amendments to Sec. 410.62 and Sec. 411.351 which are effective July 1, 2009.

Comment Date: Comments will be considered if we receive them at one of the addresses provided below, no later than 5 p.m. e.s.t. on December 29, 2008.

Lack of interest derails Medicare B drug program

By Jane Cys, AMNews correspondent. Nov. 10, 2008 in American Medical News The alternative purchasing system for drugs given in the office had only about 4,200 physicians and one drug vendor sign on in three years. Randolph Johnston, MD, a Cheyenne, Wyo., ophthalmologist, jumped at the chance to sign up for Medicare's competitive acquisition program in 2006. As a CAP participant, he no longer would have to buy the Part B drugs his practice used and then bill patients for them; instead, a drug vendor chosen by the government would take on those roles. It seemed to make financial sense. Because some of Dr. Johnston's patients had trouble paying for their office-administered drugs, the practice would get small monthly payments and carry over the balance -- often thousands of dollars. But administrative hassles, drug delivery problems and other troubles quickly dampened his enthusiasm. "After three months of the program, we wrote a letter and begged to be let out," said the vitreoretinal specialist, who will become the American Academy of Ophthalmology's president-elect in January 2009. Although CAP is voluntary, he was stuck with it for the rest of the year. Looking ahead CMS officials urged Medicare participants to use the CAP hiatus to suggest changes that could improve the program. The agency will hold an open door forum on the issue in December. The AMA remains unsure about the program's viability, given inadequate pay to doctors for many Part B drugs, wrote AMA Executive Vice President and CEO Michael D. Maves, MD, MBA, in an August letter to CMS. Because payments to vendors under CAP are discounted, even below the average rates that doctors receive under Medicare, many vendors likely will decide CAP isn't worth it, he said.