AMA Legislative News


Medicare/SCHIP Update 

On Dec. 19, Congress passed legislation that would replace a scheduled 10.1 percent cut in 2008 Medicare physician payments with a 0.5 percent increase through June 30, 2008.

According to AMA's eVoice, AMA led a $3 million grassroots campaign to avert the scheduled payment cut. As a result, Congress increased spending for Medicare physician payments by $3.1 billion.

Aggressive AMA lobbying and advertising generated more than 50,000 phone calls and 500,000 contacts by physicians and patients to Congress. There were also 8,200 targeted television commercials; 6 million Internet impressions; 13 AMA-AARP op-ed pieces placed in key states; six published letters to the editor, including two in the Wall Street Journal; and a media campaign that resulted in 267 million media impressions, including a satellite media tour that reached 15 million people, and a radio news release that reached 82 million told medicine's story. Despite AMA's efforts, the association is disappointed according to the publication, in the failure of Congress to provide-at minimum-a two-year payment update that is paid for and that creates a pathway for the long-term replacement of the flawed payment formula. The AMA will work with state and specialty medical societies to execute strategies next year that will achieve this goal.

At the same time, Congress sent the President a bill extending SCHIP. Here are some highlights of the legislation:

  • Replaces 10.1 percent cut with 0.5 percent increase through June 30, 2008. If Congress fails to take action before the end of next June, physicians will face a cut of approximately 10.6 percent.
  • Authorizes an additional 1.5 percent bonus for Medicare physician quality reporting initiative (PQRI activities) through Dec. 31, 2008, and extends floor for work-geographic adjustment and physician scarcity bonus through June 30, 2008.
  • Includes budget offsets that remove $1.5 billion from Medicare Advantage stabilization fund; eliminates physician payment fund carried over from 2006 Medicare package and reduces payments for some Part B drugs.
  • Extends therapy cap exceptions, pathology billing exception and premium assistance for some low-income seniors for six months.
  • Extends SCHIP funding through March 31, 2009 and provided additional funding for current enrollment.

Key policies that were debated during the Congressional SCHIP deliberations, but were not included in legislation approved at the eleventh hour:

  • Place limitations on physician-owned hospitals.
  • Establish electronic prescribing requirement or reductions in payments for paper scripts.
  • Establish imaging provisions to reduce payments, mandate accreditation or establish appropriateness demonstration projects.
  • Change the direction of Medicare's Quality Improvement Organization (QIO) program to focus on enforcement and require changes in QIO Boards.
  • Adopt provisions to alter or supplant the role of the Relative Value Update committee and provide Medicare with authority to make arbitrary payment cuts for rapidly growing services.
  • Create specialty specific expenditure targets.

For more information on the Congressional SCHIP deliberations over the past few months, visit The SCHIP Standoff.

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From the AMA

Are you informed about presidential candidates' health care proposals?

As health care reform is shaping up to be one of the most important issues in the 2008 presidential election, a page on the AMA Web site now provides links directly to each declared candidate's health care proposal. The AMA's 2008 Advocacy Agenda includes efforts to expand health coverage for the uninsured, reform the Medicare physician payment system, reform the medical liability system, improve the health of the public, and more. Remember to keep these issues in mind when you're evaluating the proposals and platforms of the 2008 presidential candidates.