Medicare News

  • Modern Healthcare reports that HHS Secretary Michael Leavitt “said that a Medicare bill expected to emerge from the Senate later this week should tie the use of health information technology to higher Medicare physician reimbursement.” This is the Senate Finance Committee’s bill to avoid the 10.1% cut in Medicare Part B reimbursement to physicians that will be effective on January 1, 2008, unless Congress acts.
  • The AMA News reports that the AMA House of Delegates recently voted to call for national legislation to allow physicians to bill patients for fees that Medicare does not cover. Currently, physicians may choose whether or not to participate in Part B. Participating physicians generally receive 5% more money from Medicare than non-participating physicians but participating physicians may only balance bill patients for the Medicare deductible and co-insurance. A non-participating physician may balance bill for these items plus no more than 15% above the Medicare reimbursement amount. Several states, including Massachusetts, prohibit physicians for balance billing this 15% surcharge. The AMA wants Medicare to preempt those state laws.
  • HHS has appealed a U.S. District Court for the District of Columbia order that would have required HHS to provide the Center for the Study of Services HHS claims data that the Center planned to use for the purpose of evaluating provider quality of care. The lower court order has been stayed pending this appeal to the U.S. Court of Appeals for the District of Columbia Circuit. The Center’s press release is available here.