Endocrine Insider
July 10, 2008

After months-long debate, on Wednesday July 9, Senators voted 69-30 to invoke cloture and limit discussion, allowing H.R. 6331, the "Medicare Improvements for Patients and Providers Act of 2008," to be passed by unanimous consent. Senator Ted Kennedy (D-MA) returned to the Senate for the first time since being diagnosed with brain cancer to cast his vote, helping to obtain the 60 votes needed to invoke cloture. Democrats were one vote shy of reaching this mark when the bill was brought up in late June. The bill blocks physician payment cuts and provides a 0.5 percent increase for payments through the rest of 2008, and another 1.1 percent increase in 2009. In addition, the legislation also includes these provisions:

• Incentives for physicians to use an e-prescribing system in 2009 and 2010, with a requirement that they use it by 2011. For those failing to use an e-prescribing system in 2011, payments will be reduced up to two percent. Excluded are those who write prescriptions infrequently or are under financial hardship.
• Extension of the Physician Quality Reporting Initiative through 2010 and a bonus increase from 1.5 percent to two percent for 2009 and 2010.
• Increased funding for the Medical Home Demonstration Project established in 2006 and permission for the HHS Secretary to expand the scope of the demonstration if certain cost savings and/or quality targets are met.

The House passed H.R. 6331 by a veto-proof margin on June 24, prompting the Senate to take up the legislation on June 26. At that time, a failed cloture attempt by Senate Majority Leader Harry Reid (D-NV) resulted in the bill being tabled until after the July 4 recess, forcing the Centers for Medicare and Medicaid Services to delay the 10.6 percent pay cuts temporarily through an administrative process.

During the congressional recess, physician groups including The Endocrine Society worked together with the American Medical Association to remind senators of the importance of passing H.R. 6331 and the negative impact that would occur if the legislation was not approved. Speaking with one voice, the medical community was able to influence the final outcome of this legislation.

The bill must now be sent to the president for approval. It is uncertain at this time whether the president will sign or veto the legislation, but the support the bill has received in both the Senate and the House indicates that Congress would be able to override a presidential veto.

The Endocrine Society will continue its strong efforts to ensure fair physician reimbursement. Look for updates in future issues of Endocrine Insider.