April 08, 2008

TAKE ACTION
Contact Congress! Tell them to support a real plan on Medicare payment!
Send a Letter to Congress! Late last year, Congress froze the scheduled Medicare payment cut for just six months. That time is almost up and we must once again make our voices heard as Congress works now to stop a payment cut amounting to more than 15% over the next 18 months.

Physician Payment Bill Introduced in the Senate
On March 13th, Sen. Debbie Stabenow (D-MI) introduced the "Save Medicare Act of 2008" (S. 2785). The bill aims to address the projected physician payment cuts for the next 18 months. Additionally, the bill would extend the Physician Quality Reporting Program (PQRI), incentive payment programs for physician scarcity areas, and the floor on Medicare work geographic adjustment (GPCI). Notably, the bill also includes two important "Senses of the Senate" regarding fiscal responsibility and quality reporting.

The specific provisions of the bill include:

• Extension of current law to provide positive 0.5 percent updates to physicians for all of 2008; thus, preventing the scheduled 10.6 percent cut on July 1st.

• 1.8 percent update to all physicians for all of 2009; thus, preventing anticipated cuts.

• Extension of the PQRI program until January 1, 2010.

• Extension of the Medicare incentive payment program for physician scarcity areas through January 1, 2010.

• Extension of the floor on Medicare work geographic adjustment (GPCI) through January 1, 2010.

The bill includes a "Sense of the Senate Regarding Fiscal Responsibility" which requests this bill be deficit neutral over the 5-year period beginning October 1, 2008 and requests that Congress address the challenges facing the Medicare program with fiscal responsibility. The "Sense of the Senate Regarding Quality" requests that the Medicare program provide physicians with positive payment incentives to participate in voluntary quality programs with financing for these incentives being non-punitive and therefore exempt from the Medicare physician fee schedule budget neutrality requirements.

Ray Quintero (rquintero@osteopathic.org )

New Bill Gives FDA Authority to Regulate Tobacco Products
On Wednesday, April 2, the House Energy and Commerce Committee approved legislation, by a vote of 38-12, which would give the Food and Drug Administration (FDA) the authority to regulate tobacco products.

This new authority would set up a tobacco-oversight office at the agency that would be funded primarily by user fees from the industry. The legislation will allow the FDA to monitor cigarette labeling, ban flavored cigarettes and limit advertisements such as those claiming that one product is safer than others. The agency wouldn't be able to outlaw cigarettes or require zero nicotine levels.

Major health groups including the AOA have expressed support for this legislation, as have many Democrats and the nation's largest cigarette maker, Philip Morris USA. While the legislation has 220 co-sponsors in the House and 55 co-sponsors in the Senate, its success isn't guaranteed this year, and it could be vetoed by the President.

The FDA has not endorsed the bill. Last year, FDA Commissioner Andrew von Eschenbach said it would be difficult to implement and would burden an already-strained regulatory body, in addition to being costly. However, estimates show that the FDA will collect $85 million from tobacco companies in the first year and eventually assess fees of $712 million in the next decade.

Cate Blankenburg (cblankenburg@osteopathic.org) 

AOA President Writes Congress to Stop Genetic Discrimination
The Coalition for Genetic Fairness, of which AOA is a member, is advocating for passage of legislation that would prohibit discrimination in insurance and employment based on an individual's genetic information. AOA President Peter B. Ajluni, DO wrote to Senate Majority Leader Harry Reid (D-NV) April 1, requesting that the "Genetic Nondiscrimination in Insurance Act" (S.358) be brought to the Senate Floor for a vote as soon as possible. Proponents of the legislation believe that patients should not forgo genetic testing out of concern that they may experience discrimination in insurance decisions or employment.

Susan Friedman (sfriedman@osteopathic.org ) 

"Protecting the Medicaid Safety Net Act of 2008"
On April 3, the House Energy and Commerce Committee examined legislation introduced by Chairman John Dingell (D-MI) and Rep. Tim Murphy (R-PA) that would place a temporary one-year moratorium on seven Administration-imposed Medicaid regulations, including the Medicaid Graduate Medical Education proposed rule. These regulations would make significant cuts to the Medicaid program over the next five years. The "Protecting the Medicaid Safety Net Act of 2008," (H.R. 5613) would "give Congress time to better evaluate and assess" the impact of the regulations.

During the past year, the U.S. Department of Health and Human Services (HHS) has issued a number of regulations that would reverse long-standing Medicaid policies and eliminate federal payments for a variety of critical Medicaid functions. In addition to the GME payments proposed rule, the other affected regulations would affect payments to: public safety net institutions; coverage of rehabilitation services for people with disabilities; outreach and enrollment in schools as well as specialized medical transportation to school for children covered by Medicaid; coverage of hospital clinic services; case management services that allow people with disabilities to remain in the community; state provider tax laws; and appeals filed through HHS. Last December, Congress enacted a temporary moratorium on some of the regulations. However, all are set to expire before July 2008.

The AOA, along with several national organizations including the National Governors Association, the National Association of State Medicaid Directors, and the American Public Human Services Association, have supported provisions in this legislation

Cate Blankenburg (cblankenburg@osteopathic.org)

Sen. Christopher J. Dodd, D-Conn - Dominican Republic - 1966-68
Rep. Sam Farr, D-Calif. - Colombia - 1964-66
Rep. Michael M. Honda, D-Calif. - El Salvador - 1965-67
Rep. Tom Petri, R-Wis. - Somalia - 1966-67
Rep. Christopher Shays, R-Conn. - Fiji - 1968-70
Rep. James T. Walsh, R-N.Y. - Nepal - 1970-72

Brandon Fuller (bfuller@osteopathic.org)