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November 9, 20071. Act Now: Extend the Medicaid Moratorium and Reverse Medicare Physician Pay Cuts 2. Congress to Finalize NIH, VA Research Budget 1. Act Now: Extend the Medicaid Moratorium and Reverse Medicare Physician Pay Cuts Without congressional action to extend the Medicaid moratorium, the Centers for Medicare & Medicaid Services (CMS) could restrict Medicaid funding for graduate medical education (GME) as soon as May 2008. Starting January 1, 2008, a CMS final rule will cut Medicare physician payments by 10% unless Congress reverses the cuts. The Alliance for Academic Internal Medicine urges its members to encourage their congressional representatives to act now to preserve Medicaid funding for GME and reverse Medicare physician pay cuts. In May 2007, Congress responded to the CMS proposed rule to end federal support for GME by passing, within the fiscal year (FY) 2007 supplemental appropriations bill, language that places a one-year moratorium on any such restriction on GME funding. The moratorium will last until May 23, 2008. At this time, it is important Congress extends the moratorium or creates other legislative language that will curb the CMS strategy to restrict federal funding for GME. Meanwhile, approximately 60% of physicians will have to stop accepting Medicare patients if the CMS payment cuts are enacted. Earlier this year, the US House of Representatives passed legislation that provided a two-year solution. The legislation would have covered the cost of the reversal in physician pay cuts by scaling back on payments to private health plans in Medicare; however, the Senate would not agree to the legislative provisions. Currently, members of the Senate Finance Committee are trying to assemble a package of cuts from other programs in Medicare. According to Congressional Quarterly, members of the Senate Finance Committee do not believe they will be able to find offsets to pay for more than a one-year fix. To assist members in contacting their members of Congress, a sample letter is included below. [Date] Dear Senator/Representative [Name]: As [Title], I urge you to act now to extend the Medicaid moratorium on the implementation of a proposed rule relating to the federal-state partnerships under Medicaid. The moratorium, which keeps the Centers for Medicare & Medicaid Services (CMS) from restricting Medicaid funding for graduate medical education (GME), expires May 23, 2008. While the moratorium provides a temporary fix, you and other members of Congress must work with national organizations to preserve Medicaid funding for GME. If CMS eliminates federal funding for GME through Medicaid, federal GME funding would decrease by approximately $1.8 billion over 5 years. In addition, I encourage you to reverse the 10% cut to physician payments which will take effect January 1, 2008. I ask that you provide at least a two-year solution to physician payments under Medicare with positive updates. Without these updates, a majority of physicians will be forced to limit the number of Medicare beneficiaries they accept. Thank you for your consideration of this request. If I can be of assistance to you as you consider these issues, please contact me at [telephone number] or [email address]. Sincerely, 2. Congress to Finalize NIH, VA Research Budget While the federal government is currently funded under a continuing resolution that maintains federal funding at last year’s levels, Congress is working to complete the fiscal year (FY) 2008 appropriations bills. The US House of Representatives and Senate have met in conference to negotiate the differences in the appropriations bills that fund the Department of Health and Human Services (HHS)—including the National Institutes of Health (NIH), the Agency for Healthcare Research and Quality, and the Health Resources and Services Administration—as well as the appropriations bill funding the Department of Veterans Affairs (VA). The negotiated bills incorporate aspects of each chamber’s original bills but often set entirely new funding levels. Highlights of the new bills include:
President George W. Bush has threatened to veto the Labor-HHS bill, arguing that it is a fiscally irresponsible measure. Congress has provided $9.8 billion more than President Bush’s FY 2008 budget request. Meanwhile, it is unclear when Congress will send the VA bill to President Bush for his signature. In a press release, the Disabled American Veterans argued that “despite widespread support for the increase [in funding included in the bill], Congress and the Administration have not enacted a new appropriation for the new fiscal year which began on October 1—five weeks ago. As a result, VA cannot yet use any of that pending increase to hire new doctors or nurses, purchase new medical equipment, or increase medical care delivery to waiting veterans.” The veterans service organization urged Congress and the Administration to enact the measure by Veterans Day. The Alliance for Academic Internal Medicine—the nation’s largest academically focused specialty organization—consists of the Association of Professors of Medicine, the Association of Program Directors in Internal Medicine, the Association of Subspecialty Professors, the Clerkship Directors in Internal Medicine, and the Administrators of Internal Medicine. Please contact AAIM Vice President for Policy Charles P. Clayton (cclayton@im.org), AAIM Policy Associate Nicole V. Baptista (nbaptista@im.org), or AAIM Policy Assistant Allison L. Haupt (ahaupt@im.org) at (202) 861-9351 with questions or comments about this week’s Merlin. |
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