Updated December 16, 2009

FY 2010 Appropriations

On December 8, 2009 , the U.S. House of Representatives passed the FY 2010 Consolidated Appropriation Act, which includes the FY2010 appropriations for six federal agencies. Labor-Health and Human Services-Education will receive $163.6 billion, including $31 billion for the National Institutes of Health ($250 million above the request and $692 million above 2009, for biomedical research to improve health and reduce health care expenditures). On Sunday, December 13, 2009 the U.S. Senate approved the FY 2010 Consolidated Appropriation Act Omnibus bill.

Physician Payment Fix
On Wednesday, December 16, the House of Representatives included in the FY 2010 defense appropriations legislation a 60-day patch to the Medicare physician payment cuts. The patch would delay by 60 days the implementation of the scheduled 21.2 percent cut in Medicare physician payments. The Medicare physician payment rate will be frozen at the current reimbursement rate throught February 28, 2010. This will give lawmakers time to move forward with a longer-term revamp of the physician payment formula as part of health reform legislation. The Senate is scheduled to debate and vote on the FY 2010 defense appropriations later this week.

Health Care Reform Legislation

Senators continue debating the Senate version of health care reform over the last week. The amendment proposed by Senator Byron Dorgan (D-ND) that would have eased restrictions on drug reimportation was a primary focus of the debate for the last week. The Senate defeated this amendment; had it passed, it would have violated the agreement made earlier this year by the White House with the Pharmaceutical Research and Manufacturers of America (PhRMA) to oppose importation and to help close the "donut hole" under the Medicare Part D prescription drug program of the United States, which may have resulted in the PhRMA’s opposition to the Senate bill. (The so-called 'donut hole' is the difference of the initial coverage limit and the catastrophic coverage threshold.)

At a special caucus on the evening of Monday, December 14, all 58 Democrats and the two independents who sit with the party, Sen. Joseph Lieberman (I-CT) and Sen. Bernie Sanders (I-VT), dropped a plan to expand Medicare, which should help build enough support to pass the health care reform legislation.

Amendment on Medicare Consultation Services
Senator Arlen Specter (R- PA) filed Amendment No. 3163, which delays the implementation of Centers for Medicare and Medicaid Services (CMS) regulations eliminating consultation service codes. In addition, the amendment will require a coding structure adequately accounting for consultation services. For this to be considered for action, Senators need to hear from as many physicians as possible. With just a few days left for debate on health care reform, please contact your Senators TODAY asking them to vote in favor of Amendment No. 3163 as part of health care reform legislation.

Next Steps

The Senate Leadership is still waiting for the Congressional Budget Office (CBO)’s estimate on the alternate option to the public plan as it was negotiated by 10 senators last week (see recap of Senate activities). CBO is expected to release its score later this week. It's been estimated that the Senate would need to six to nine days for three cloture votes and a vote on final passage, which means Senate Majority Leader Harry Reid (D-NV) must file cloture this week in order to ensure passage before the December recess as is desired by Senate Democrats and President Obama.