Summer has been busy and I haven’t had time to write as much as I’d like. Some important votes have slipped by without comment. One that I think is of particular interest is the vote on June 24 on H.R. 6331: Medicare Improvement for Patients and Providers Act of 2008. Medicare recipients and the physicians who care for them should take special note.

On July 1st 2008, physicians participating in the Medicare program were scheduled to receive a 10 percent cut in reimbursement. An additional 5 percent cut was to take place in 2009. These cuts, if enacted, could have been devastating to both physicians, who are struggling to maintain the solvency of their practices in the face of reimbursement reductions by state, federal and private payers, and to Medicare recipients, who are faced with increasing difficulty in finding physicans willing to treat Medicare patients. According to the American Medical Association, as many as 60% of physicians would have been forced to limit their services to Medicare recipients under the proposed cuts.

In an effort to prevent these cuts from taking place, Democrats in the House, led by Rep. Charles Rangel, introduced H.R. 6331. In addition to to stopping the physician pay cuts, the bill provided for a number of modest improvements to the Medicare program to aid beneficiaries including:

• Coverage of additional preventive services
• Elimination of late enrollment penalties for the part D drug benefit
• Coverage of pulmonary and cardiac rehabilitation
• Elimination of higher co-payments for mental health services

Prior to the vote, President Bush threatened to veto the bill because it would have reduced payments to Medicare Advantage plans - private health insurance plans that offer alternatives to traditional Medicare under contract with CMS. Such plans currently receive, on average, about 12% more than the cost of services for recipients in traditional Medicare. Outside the Administration, there is widespread feeling that these plans, which are supposed to reduce costs through careful medical management, should be receiving reimbursements at a level lower than the costs of traditional Medicare, although insurance companies argue that the cuts will increase out-of-pocket costs and decrease options for Medicare Advantage recipients.

When the bill came to a vote on June 24, Peter Roskam voted no, siding with the Bush administration in its desire to allow the pay cuts to take effect. The bill passed but was vetoed by the President on July 15. That veto was quickly overridden by the House and Senate and has become law.

Physicians and Medicare recipients in the 6th district should ask Peter Roskam why he voted to support pay cuts for Medicare physicians. Roskam can be reached at his Washington office at (202) 225-4561 or in Bloomingdale at (630) 893-9670.