July 16, 2008 - Earlier this week President Bush vetoed the Medicare Improvements for Patients and Providers Act (HR 6331) because it excluded a 10.6 percent pay cut to doctors who treat patients in the Medicare program. However, on July 15 the U.S. House of Representatives and Senate voted overwhelmingly voted to override the veto.
The House overrode the veto by a margin of 383-41 and the Senate vote was 70-26.
The bill was originally passed by the House of Representatives on June 24, and by the Senate July 9. Last December Congress froze reimbursement rates at the 2007 level for six months after the Centers for Medicare and Medicaid Services (CMS) released a list of lower proposed rates for 2008. The act includes an 18-month extension of the 2007 reimbursement rates and a 1.1 percent payment increase.
The 10.6 percent physician payment cut called for by Medicare's Sustainable Growth Rate (SGR) formula was originally supposed to go into effect on July 1. The measure also eliminates a 5 percent cut that was set for Jan. 1, 2009.
"It has been a long and winding road, but today we celebrate that Congress heard the voices of millions of patients and physicians and voted to override President Bush's veto and protect the health of America," said Nancy H. Nielsen, M.D., president of the American Medical Association. "The 10.6 percent cut in payments to physicians who treat Medicare patients would have been devastating to seniors and the disabled who rely on Medicare for the health care they need, as well as to military families who rely on TRICARE for their healthcare."
She said the congressional debate underscores the need for lawmakers to permanently replace the flawed Medicare physician payment formula so physicians can focus on taking care of patients.
"We are encouraged that this bill stops Medicare cuts for the next 18 months and gives physicians a 1.1 percent payment update to help payments keep up with the increasing cost of providing health care to seniors," Dr. Nielsen said. "Current Medicare payments to physicians are about what they were in 2001, while the cost of running a medical practice has increased substantially."
The legislation calls for providers of advanced diagnostic imaging services (MR, CT, PET, and nuclear medicine) to be accredited in order to receive payment for the technical component of those services. The bill also establishes a two-year voluntary demonstration program to test the use of physician developed appropriateness criteria.
"The final passage of this bill is a victory for medicine, radiology and all our patients," stated James H. Thrall, M.D., FACR, chair of the ACR Board of Chancellors. "Not only did this congressional action end the specter of a 10.6 percent cut for all physicians, it also included the provisions of mandatory accreditation for those who perform advanced imaging services, and an appropriateness criteria pilot program to help physicians prescribe the most appropriate imaging exam. The College advocated strongly for these provisions. On behalf of ACR, I would like to extend a sincere thanks to those House and Senate members who voted to override the veto and support patients and the physicians who treat them."
The American Public Health Association (APHA) also applauded the House and Senate for overriding the president's veto of a Medicare bill that would improve access to preventive services and strengthen low-income protections against rising Medicare costs.
"This bill is a victory for our nation's seniors and individuals with disabilities," said Georges C. Benjamin, M.D., FACP, FACEP (E), executive director of APHA. "It provides those enrolled in the Medicare program with improved and affordable preventive and mental health benefits and also ensures they have access to the providers they need."
Nearly every health lobby in Washington, D.C supported the bill. The only lobby groups opposing the bill's passage were those supported by health insurance providers.
The bill contains a number of important provisions, including an extension of expiring provisions that boost payments in rural areas, bonuses for quality reporting, a phase-out of higher co-pays for mental health services, an expansion of the medical home demonstration project and increased payments for anesthesia teaching programs.