Prospects for congressional action to block a 10% cut in Medicare payments to pathologists and other physicians next year are murky at press time, as House and Senate negotiators remain at odds over a fee fix and how to pay for it. Though blocking the cut could be attached to an omnibus spending bill, Senate Finance chairman Max Baucus (D-MT) has raised the possibility that the pay issue may even be put off until January.

Finance leaders, unable to get committee members to agree on markup of a legislative fee fix and other Medicare policy reforms, have been meeting directly with their House counterparts to resolve key sticking points. One is whether to grant a one- or two-year fee increase; another is how much to cut Medicare managed care to finance the increase. The House has approved a 0.5% raise in 2008 and 2009 and a reduction of managed care rates to 100% of fee-for-service levels. Complicating the picture is the President’s threat to veto any cuts to the Medicare Advantage program.

Also hanging in the balance before Congress adjourns for the year is the House-passed extension, through 2009, of the "grandfather" protection for independent labs that bill Part B for the technical component of pathology services to hospital patients. This expires December 31 of this year, and Medicare intends to eliminate such billings as of January 1 unless Congress says otherwise.

December 17, 2007 - Table of Contents

NIR December 17, 2007 (full PDF issue)

CMS Forging Ahead with Lab Bidding Demo in San Diego

Time Running Out for Physician Fee Fix

Advisory Panel Prescribes Changes for CMS, FDA in Genetic Test Oversight

January 1—Key Deadline for Use of National Provider Identifier

Medicare Improper Claims Payment Continues to Drop