The Medicare Patient and Providers Act

Published by Steve Hedberg on August 4, 2008 Under Medicare

Congress sent a big message to the President by over ruling his veto of the Medicare Bill. The Medicare Improvement for Patients and Providers Act of 2008, bill H.R. 6331, was introduced to the house of representatives on Jun 20, 2008. This bill would be cause for much debate over the course of the next month, and ultimately resulted in a very strong statement by Congress to the President.

One of the major parts of this bill is intended to ensure that payments to doctors who participate in the Medicare program are not cut.

Since 1997 the amount of money that Medicare pays doctors has been based off of the state of the economy. When state of the economy is healthy Medicare increases the pay. When it is poor, the doctors pay is decreased. Using this formula the rate of doctors pay would be cut by 10.6% this year.

H.R. 6331 is designed to stop doctors pay from being cut and guarantees an increase in their pay of 1.1% over the next two years.

Changes to Medicare Advantage Plans

Instead of cutting the doctors pay, the bill instead cuts the payments to Medicare Advantage Plans.

A Medicare Advantage Plan is an insurance plan that is available from private insurance companies. It is available to those who are eligible for Medicare. The federal government reimburses the private insurance companies a set amount for each person that signs up.

The private insurance companies are obliged to offer all of the same services that are offered by traditional Medicare, but can choose how they cover certain parts. For instance the co-pay for a doctors visit might be less when using a Medicare Advantage Plan, but long term care might cost more.

About 9 million Americans currently use Medicare Advantage Plans, which cost about 17% more than traditional Medicare does.

Critics of the bill cite that cutting the payments to Medicare Advantage Plans will result in higher co-pays and reduced benefits for those that use these plans.

Other Changes to Medicare

Bill H.R. 6331 will also affect the benefits of those who receive traditional Medicare benefits. The bill also will reduce the copay required for mental health treatment 60% over the next few years.

Several types of prescription anxiety and sleeping drugs will begin being covered in 2013 as well.

The Improvement for Patients and Providers Act also allows for Medicare to decide what types of preventative procedures to cover without asking approval from congress.

Congress Sends a Message to the President

For days after its introduction, Bill H.R. 6331 was passed by a majority in the House of Representatives and sent to the Senate. On July 9, 2008, the Senate passed the bill as well and it was sent to the president.

Since the conception of the bill Bush has stated that he will veto it and he lived up to his word on July 15, 2008. In Bush’s statement to the House of Representatives he stated that he felt that the bill would reduce the types of private options available to those who use Medicare plans offered by private insurance companies.

Bush said, “it is estimated that this bill would decrease MA enrollment by about 2.3 million individuals in 2013 relative to the program’s current baseline;”

Within hours of President Bush’s veto, the House of Representatives and the Senate voted to overrule his veto.

The Bill became law the next day on July 16, 2008. This is the fourth time congress has overridden Bush’s Veto.

In many ways Bush’s veto and Congress’s subsequent vote to override his veto are only part of a battle over attempts to privatize Medicare by the Bush administration.

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