The Society Responds to Health Care Reform Legislation
On Monday, September 21, 2009, the Alliance of Specialty Medicine, of which the Heart Rhythm Society is an active member, sent a letter in response to “America’s Healthy Future Act of 2009” introduced September 16 by Senator Max Baucus (D-MT). In the letter, the Alliance explains that at this time, it cannot support the legislation unless the following changes among others are made:
- provide a permanent fix to the Medicare Physician Payment
- strike out the Medicare Commission proposal
- prevent a primary care bonus at the expense of specialists
- amend the health information technology timeline
- keep the PQRI a voluntary program (do not eliminate the incentives and replace them by penalties)
- provide medical liability reform
- take into account the shortage of specialists for the National Workforce Strategy
Read full text (PDF, 160K) of the Alliance letter with the Heart Rhythm Society as signatoree.
Activities in the Senate
On Tuesday, Chairman Baucus released a modified version of the bill that added more than 110 amendments proposed by members of the Senate Finance Committee. Baucus accepted these admendments with the hope that by doing so, it would shorten the mark-up session duration as well as to gather additional support. During the opening statement, the members of the Committee expressed their opinion on the current bill and were able to ask questions about the bill to the Office of Management and Budget, legislative counsel and Committee staff to better understand the modified bill and its potential impact.
Among the amendments impacting physicians are (changes are boldfaced in green):
- Accountable Care Organizations (ACO): The approved amendment clarifies that physicians can participate in ACOs regardless of their specialty. The new definition reads as follows:
“Eligible Practitioners would be defined as physicians regardless of specialty, nurse practitioners, ;physician assistants, clinical nurse specialists, and other practitioners or suppliers as the Secretary determines appropriate”.
- CMS Innovation Center: The original bill proposed the creation of a CMS Innovation Center, which would be testing, evaluating, and expanding different payment structures and methodologies which aim to foster patient-centered care, improve quality, and slow the rate of Medicare cost growth. The accepted amendments further define the criteria that a model must meet to be considered and tested by the CMS Innovation Center.
- Physician Quality Reporting Initiatives (PQRI): This initial provision would make changes to the voluntary PQRI program, including requiring all eligible health professionals to participate by 2011, expand the Medicare physician feedback program, and penalize physicians who utilize significantly more resources than their peers. The amendments accepted by Chairman Baucus change the timeline for the phasing out of the bonus payment and the phasing in of the penalties. This provision creates a mandatory PQRI. The new language reads as follows: “The Chairman‘s Mark would extend PQRI incentive payments beyond 2010. Eligible professionals who successfully report in 2010 would receive a one percent bonus in 2011. Eligible professionals who successfully report in 2011 would receive a 0.5 percent bonus in 2012. Eligible professionals who failed to participate successfully in the program would face a 1.5 percent payment penalty in 2013, based on their 2012 reporting period. The incentive payments and adjustments in payment would be based on the allowed charges for all covered services furnished by the eligible professional, based on the applicable percent of the fee schedule amount. For 2013, the applicable percent would be calculated as 98.5 percent of their total allowed charges. For 2014 and in subsequent years, the penalties for non-reporting would be two percent, calculated as 98 percent of their total allowed charges. "
More than 500 remaining amendments are being proposed for vote during the Committee mark-up session. Baucus expects to complete the mark-up this week and hopes to bring the bill to the Senate Floor next week.
The mission of the Alliance of Specialty Medicine is to develop sound federal health care policy that fosters patient access to the highest quality specialty care and improves timely access to high quality medical care for all Americans. On Tuesday, September 22, the Alliance sent letters on four particular areas to all the Members of the Senate Finance Committee explaining its positions and requesting their support to either vote for or oppose particular amendments:
Activities in the House
In the U.S House of Representatives the Committee will be marking up 60 amendments, although the Energy and Commerce Committee already passed health care reform legislation before August recess. House Speaker Nancy Pelosi (D-CA) would like to have a vote on the House legislation before the October recess.
