Action in the House

The House Energy and Commerce Committee Incorporated Additional Amendments to Their Health Care Reform Legislation

On Wednesday, September 23, 2009, the Energy and Commerce Committee held a mark-up session to vote on additional sixty amendments that were not considered during their original vote prior to the August Recess. Among the amendments approved by the Committee were:

• “Establishment of a common set of risk adjusted outcomes measures (such avoidable hospitalizations and inpatient readmission for ambulatory care sensitive conditions, medication management to prevent adverse drug events and promote adherence, etc) and reporting procedures for Medicare and Medicaid to evaluate performance for integrated Medicare-Medicaid programs for dual eligibles in serving a comparable group of beneficiaries under the original Medicare fee for service, Medicare advantage and Medicaid “
• Amendment to the Physician Sunshine Act provision: The Committee added a reporting requirement for physicians-owned entities. The amendment states that: “any applicable manufacturers, group purchasing organizations or distributors should submit to the Secretary the following information regarding any ownership or investments interests held by a physician (or an immediate family member of the physician) in the applicable manufacturers, group purchasing organizations or distributors:
  1. The dollars amount invested by each physician holding such ownership or investment
  2. The value and terms of each such an ownership and investment interest
  3. Any payment or transfer of valued provided to a physician holding such ownership or investment
  4. Any other information regarding ownership or investment the Secretary determine appropriate. “

The Energy and Commerce health care legislation was approved by the Committee. House staff is currently working at merging  the three Committees legislation (from the Energy and Commerce Committee, the Education and Labor Committee version and the Ways and Means Committee version) into one bill. Nancy Pelosi (D-CA), Speaker of the House, needs to reduce the price tag of the House bill to under $900 billion over ten years in order to conform to President Obama’s wishes. The House Democratic Leadership is considering some of the Senate Finance Committee provisions that provide an alternative way of paying for the reform.

Action in the Senate

Senate Finance Committee’s Legislation Includes a More Stringent Medicare Commission Proposal to Reduce Health Care Spending Growth

The Senate Finance Committee reviewed 58 amendments (out of the 500 proposed amendments) during last week’s mark-up session. Among the many amendments passed, the amendment proposed by Senator Jay Rockefeller (D- WV) would directly impact physicians. Rockefeller's amendment would create a permanent Medicare Commission with themission to curve spending growth in the Medicare Program. The proposal would require the Commission to implement policies that reduce health care growth by at least 1.5 percentannually starting in 2014. If the growth reduction were not met, the Secretary of Health and Human Services would have the authority to make up the balance decrease necessary through a cumulative reduction in provider reimbursement. Congress would have 30 days to review the proposed cuts package, and they would need a two-third majority vote to override it.

According to the proposal, Commissioners would be appointed for a six-year term by the President and would have to be approved by the Senate Finance Committee. Those appointed as commissioners would have to be free of any conflict and held to standards of disclosure and accountability.

As stated in the letter sent last week to the Senate Finance Committee members, the Society is very concerned that this new Commission — which would make important health care decisions without the clinical expertise, resources or oversight required, could be detrimental to patient access to specialists and to patient care. Therefore, the Society is strongly opposed to this proposal. Read letter (PDF, 200K)

On Tuesday, September 29, the Senate Finance Committee began the second week of the mark-up session. The Committee debated and rejected two amendments that would have created a public plan option. 

Chairman Max Baucus (D-MT) is hoping to finish the mark-up on Thursday and start merging this legislation with the legislation approved last July by the Senate Commission on Health, Education, Labor and Pensions (HELP Committee).