Congresswoman Doris Matsui Hails Passage of Legislation to Improve Medicare, Preserve Services

Today, Rep. Doris Matsui (CA-05) joined an overwhelming majority of her colleagues in the U.S. House of Representatives in passing the Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331). The bill prevents the pending 10.6 percent reduction for Medicare physicians, enhances Medicare preventive and mental health benefits, and improves and extends programs for low-income Medicare beneficiaries.

Congresswoman Doris Matsui Hails Passage of Legislation to Improve Medicare, Preserve Services

WASHINGTON, D.C. - Today, Rep. Doris Matsui (CA-05) joined an overwhelming majority of her colleagues in the U.S. House of Representatives in passing the Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331). The bill prevents the pending 10.6 percent reduction for Medicare physicians, enhances Medicare preventive and mental health benefits, and improves and extends programs for low-income Medicare beneficiaries.

andquot;When people have access to quality care options, they stay healthier and avoid costly visits to the emergency room. Making sure that we support the physicians who provide Medicare beneficiaries with services is a critical investment in the health and well-being of our seniors, and will save money on more expensive emergency care down the line,andquot; said Rep. Matsui.

Physicians and other clinicians are paid by Medicare under a fee schedule that should increase each year to reflect the rising cost of providing care. However, a formula implemented in 1997 to control Medicare costs has had the effect of reducing Medicare's payment targets to physicians and other clinicians. As healthcare costs have risen in recent years, this formula--known as the Sustainable Growth Rate (SGR)--has mandated deeper cuts in physician payments from year to year.

To make sure that doctors are paid fairly for services rendered, and to keep those services available to Medicare beneficiaries, Congress has reversed these planned cuts in physician payments every year since 2002. The Medicare Improvements for Patients and Providers Act of 2008 stops the next planned payment reduction, and provides a modest increase instead. The bill also implements several significant reforms that will improve the quality of care that beneficiaries receive while ensuring that Medicare dollars are used efficiently. Some provisions of H.R. 6331 are as follows:

andbull;andmiddot; Maintains physician payment rates for 2008, with an increase in 2009: In July of this year, doctors are facing a 10.6 percent payment cut under the SGR. The Medicare Improvements for Patients and Providers Act stops the scheduled cut for 2008, and increases physician payments by 1.1 percent for 2009, per the recommendation of the Medicare Payment Advisory Payment Commission (MedPAC).

andbull;andmiddot; Extends and improves the Physician Quality Reporting Initiative: Evidence shows that when providers or benefit plans are required to measure the quality of care they deliver and report, quality increases and resulting public information helps patients become better healthcare consumers. H.R. 6331 extends for two years the Physician Quality Reporting Initiative under which physicians report back to Medicare on their compliance with a standard set of quality measures, and increases incentive payments for this reporting by 2 percent. The bill focuses efforts on reporting on treatment of high-cost, chronic conditions where the most dramatic improvements in quality may be made, and contains measures to reduce the administrative costs physicians face to track and report quality.

andbull;andmiddot; Increases beneficiary access to primary care services: Primary care services are one of the most critical parts of our healthcare system. Areas with more primary care doctors spend less on health care over the long term, and patients with ready access to primary care doctors live healthier lives. H.R. 6331 will expand access to and improve the quality of primary care services across the country, and will correct a mistake by the Centers for Medicare and Medicaid Services that disproportionately reduced payments for primary care compared to other services in Medicare.

andquot;Our Medicare system has been neglected for far too long, and is in dire need of improvement as an increasing number of Americans access its services. Many of our seniors and people with disabilities depend upon Medicare for vital healthcare, and we must ensure that they have access to affordable, quality health care options. We have a duty to provide for our elder citizens,andquot; said Rep. Matsui.

Forty-four million American seniors and people with disabilities depend on Medicare for their health care. H.R. 6331 seeks to make Medicare work better for every senior citizen and every person with a disability. It pays particular attention to the needs of those living in underserved areas, and beneficiaries with low incomes and less access to health care. The bill provides approximately $4.5 billion in beneficiary improvements over 5 years, as follows:

andbull;andmiddot; Improves coverage of preventive health care: Preventive services can catch health problems before they become health catastrophes. To help beneficiaries identify medical conditions and risk factors early, H.R. 6331 allows preventive services not currently covered to be paid for by the Medicare program.

andbull;andmiddot; Makes mental health care more affordable: Medicare currently requires a much higher co-payment for mental health services - 50 percent - than the 20 percent required for physical health care services. H.R. 6331 provides parity in coverage for mental health services by lowering co-payments over six years until they match other co-pays - making sure that seniors can afford the screening and treatment they need. The bill also expands the Part D prescription drug benefit so that it includes benzodiazepines and barbiturates used for mental health treatment.

andbull;andmiddot; Improves Medicare access for people with low incomes: Millions of Medicare beneficiaries are responsible for some premiums in order to access care in their doctors' offices or in hospital outpatient settings, but Medicare also has a built-in system to help low-income beneficiaries afford these essential services. H.R. 6331 extends these low-income assistance programs for Medicare beneficiaries whose annual income is below $14,040, including a vital andquot;Qualified Individualandquot; program that pays Part B premiums for beneficiaries with incomes between $12,480 and $14,040 per year.

andbull;andmiddot; Implements measures to help all beneficiaries use Medicare better: H.R. 6331 enlists Social Security to reach out to low-income seniors and people with disabilities who need particular assistance - and provides $25 million to State and local programs that help beneficiaries, their family members, or their caregivers understand and navigate the Medicare program.

andquot;Medicare is a vital part of our country's social and healthcare safety net. I am proud to support the Medicare Improvements for Patients and Providers Act because it takes timely and necessary action to secure the promise of the health and well-being of millions of America's disabled and senior citizens,andquot; said Rep. Matsui.