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Home > Medical Professionals > Health Policy and Government Relations > Physician Payment > Medicare Improvements For Patients And Providers Act of 2008

Highlights of H.R. 6331 -- Medicare Improvements For Patients And Providers Act of 2008

Highlights of H.R. 6331 -- Medicare Improvements For Patients And Providers Act of 2008

On July 15, 2008, President Bush vetoed H.R. 6331, the Medicare Improvements for Patients and Providers Act of 2008.  The main reason was the bill uses cuts to Medicare Advantage ($20 billion over five years) to finance the bill.  Within a few hours, both the House of Representatives and Senate voted overwhelmingly to override the veto – 383 to 41 in the House and 70 to 26 in the Senate.  The following are Highlights of the law:

1. Medicare Physician Payment Update – provides a .5 % increase for the rest of 2008 and a 1.1% for 2009.  A 10.6% decrease was scheduled to go into effect on July 1, 2008; however, the Centers for Medicare and Medicaid Services (CMS) instructed its contractors to not process any physician claims through July 15.  By holding claims, CMS did not allow any payments to be made at the 10.6% decrease and will now process claims using the .5% increase, retroactive to July 1, 2008.   
 
2. Welcome to Medicare Physical Exam – the eligibility period for the Welcome to Medicare Physical Exam for new beneficiaries is extended from six months to one year.  Since AAA screening is tied to this exam, it is also extended to one year beginning January 1, 2009.

3. Physician Quality Reporting Initiative – incentive payments for this voluntary program remain at 1.5% for the rest of 2008 and increase to 2% for 2009 and 2010.  This also ensures that “eligible professionals” have the opportunity to provide input for measures applicable to furnished services while these are being developed, endorsed and/or selected.  In addition, a physician feedback program will be established in 2009 to provide confidential reports to physicians that measure the resources involved in furnishing care. 

4. Value-based Purchasing – the HHS Secretary will develop a plan by May 1, 2010 for transition to a value-based purchasing program for payment under the Medicare program for covered professional services.

5. Electronic Prescribing – if eligible professionals are successful electronic prescribers for covered professional services, incentive payments will be provided to them for 2009-2013.  These include: 2% for 2009-2010, 1% for 2011-2012 and .5% for 2013.  Also, failure to be a successful electronic prescriber by 2012 will result in the following adjustments to the physician fee schedule for services provided by professionals:  99% for 2012, 98.5 for 2013 and 98% for 2014 and beyond. 

6. Diagnostic Imaging Services – accreditation requirements and appropriateness criteria for advanced diagnostic imaging services will be required beginning January 1, 2012.  This does not apply to vascular ultrasound.

7. Alternative Application of Budget Neutrality Adjustment – this adjustment will be applied to the conversion factor beginning in 2009, which should be helpful to 90 day globals.

8. Competitive Bidding – provides an 18 month delay for the Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies.  This program was scheduled to begin July 1, 2008 in 10 metropolitan statistical areas.  The Negative Pressure Wound Therapy category is also excluded.

SVS sincerely thanks our members for supporting this legislation by emailing letters and making phone calls to so many U.S. Representatives and Senators.  There was a record number of letters on this issue emailed to members of Congress through the web site this year – 915.  This victory shows the power of grassroots letters and calls with many physician and patient groups and the AARP working together to get this legislation enacted.