A1: This bill supports expansion of Medicare Advantage through regional goals of increasing availability of such plans. Unfortunately, the handwriting is on the wall and less oversight will lead to increased costs (already permissible under such plans for "expanded" coverages) and paves the way for significant reductions in coverages once plans are entrenched as the next best thing. [Answer submitted on Jun 30, 2008 8:58 AM]

A2: RE: Physical Therapy Benefits = After checking with individual PFFS's I've learned that the contract is between the patient and the PFFS. If the PFFS "limits" are based on medical necessity they will continue paying over what Medicare limit. [Answer submitted on Jul 3, 2008 2:05 PM]

A3: As a physician myself, I can assure the Congress that neither I nor any of my physician colleagues will be willing to accept or treat any medicare beneficiaries with an 11% cut in medicare reimbursement. [Answer submitted on Jul 7, 2008 2:51 PM]

A4: HR 6331 as it stands would require PFFS plans to have a formal network. Networks are well and good in major metros but may prove to be almost impossible to execute in the smaller cities and rural ares. PFFS plans do pay 100% of Medicare to willing providers. [Answer submitted on Jul 8, 2008 2:22 PM]

A5: Right now Private insurers are over subsidized by Medicare and this bill finances its self, in part, by reducing those subsidies. So the only affect is that Insurance companies see less profits. [Answer submitted on Jul 8, 2008 4:31 PM]

A6: Because this means lesser money to insurance companies,so insurance companies will reduced benefits for any Medicare Advantage Plans. Consumers have to pay more out of pocket. [Answer submitted on Jul 9, 2008 11:27 AM]

A7: Medicare Advantage plans require additional compliance and work on the part of practices. As a result, our practice (multi state and specialty) will NOT join Medicare advantage plans unless they pay at least 105% over Medicare (and some are now willing...). [Answer submitted on Jul 15, 2008 1:52 PM]

A8: To A5: Insurance Plans don't see less profits, they provide less coverage when income reduces. The only losers here are the recipients. [Answer submitted on Jul 16, 2008 3:27 PM]

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A1: As an attorney and the manager of a 5 physician cardiology practice, I can assure you that finding a doctor who accepts Medicare should this bill not be passed will be very hard to do. Although physicians were trained to help patients, they will be unable to do so if even a 1% cut goes into effect, let alone a 10% cut. This will not only affect the Medicare patients, it will also affect the society at large as physicians will immediately have to cut staff and take other drastic measures to keep their doors open. Increases consistent with inflation should be put into effect each year. [Answer submitted on Jun 30, 2008 8:22 AM]

A2: Yes, it will make it worse. Especially in rural areas. Surveys (reported by SDSMA) indicate a significant number of doctors considering not accepting new Medicare / Medicaid patients or just flat-out retiring. [Answer submitted on Jul 3, 2008 11:42 AM]

A3: Surely it will. With more and more cuts in health care costs it already is difficult to provide services to the elderly. The bigger concern is out of pocket rehabilitation expenses. I have dozens of clients right now that if this doesn't pass will be out thousands of dollars this year. [Answer submitted on Jul 7, 2008 3:59 PM]

A4: As the Director of Managed Care for a 12 provider multispecialty clinic, I second the attorney's answer (Answer 1). With a 10% cut, we will drop our 3 rural clinics. Also note that some private insurers base their fee schedule on Medicare, so we would be getting out of those networks as well. [Answer submitted on Jul 15, 2008 1:56 PM]

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A1: Psychologists support this bill, It ends decades of financial discrimination against the reimbursement of psychological services and ELIMINATES the 10.9% Medicare fee reduction that took place 7/1/08. This was already on top of a 10% reduction last year. [Answer submitted on Jul 8, 2008 10:08 PM]

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A1: Yes, it does cut payments for healthcare providers. [Answer submitted on Jul 7, 2008 1:49 PM]

A2: Yes, it seems counterintuitive considering Medicare reimbursement has been frozen over the past 5 years. Physicians will limit their access to Medicare beneficiaries if this cut goes through congress. [Answer submitted on Jul 7, 2008 2:48 PM]

A3: Yes [Answer submitted on Jul 7, 2008 3:58 PM]

A4: Contrary to previous answers this bill does not cut payments but ensures that a 10.7% cut will not happen among other things. Read the text summary 13 lines down "Increases physicians' payments." [Answer submitted on Jul 8, 2008 4:27 PM]

A5: Someone is confused or is astroturfing this site. The answer about psychologists claims that a 10.9% reduction has ALREADY taken place, on 7/1/08, 8 days ago. Three answers say a 10.7% cut WILL occur. One answser claims this bill will prevent a cut. Did a cut occur on 7/1/08? Will ANOTHER cut occur if this bill is NOT passed? [Answer submitted on Jul 9, 2008 12:08 PM]

A6: I must reaffirm answer number 4. This is one of the bills intended to delay the 10.6% decrease to the Physician?s Fee Schedule. Ultimately a permanent fix needs to be made so we can stop doing the every year, or more recently every 6 months. [Answer submitted on Jul 9, 2008 12:50 PM]

A7: Answers 4 & 6 are correct. I also manage a medical office. This bill will reverse the 10% paycut physicians received on 7/1/08. It will also prevent the additional 5% pay cut scheduled for 1/1/09. For those of you who are not familiar with this, Medicare is scheduled to gradually reduce reimbursement to physicians by 40% during the next 7 years. How will you feel if your employer told you that your paycheck will be reduced by 15% between now and Jan 1, 2009? [Answer submitted on Jul 9, 2008 8:45 PM]

A8: Answers 4, 6 & 7 are correct, however this bill only delays the cuts that are coming in the future. If you read all the background information (CBO report) there is a 21% cut in 2010 (this is how they pay for it this year). As they have in the past the push it off to the next year and so on. [Answer submitted on Jul 11, 2008 10:29 AM]

A9: To A7, Medicare is business model that is failing. Doctors are happy that their reimbursments are not going to be cut, today, but they will be cut soon, that is certain, because Medicare will be insolvent by 2019. Congress simply skirted the issue so another Congress will have to juggle this political hot potato, but it's coming down eventually and someone is going to get burned. Today's override ensures the continued and increasing taxation of today's youth and middle-aged workers. [Answer submitted on Jul 16, 2008 2:58 PM]

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A1: Tricar payments are tied to Medicare and this bill increases the Medicare payments by an averave of 1%. [Answer submitted on Jul 9, 2008 4:35 PM]

A2: Yes it will, because tricare payments are computed as a percentage of Medicare payments. [Answer submitted on Jul 9, 2008 12:05 PM]

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A1: Yes it was addressed & it was passed. It still needs the President's signature. [Answer submitted on Jul 9, 2008 6:32 PM]

A2: Didn't go through the Senate as it requres 3/5 votes and received only 58 votes because 2 senators chose not to vote. [Answer submitted on Jul 9, 2008 2:08 PM]

A3: Yes....section 144 near the end strikes transfer of ownership of oxygen equipment [Answer submitted on Jul 9, 2008 7:12 PM]

A4: The bill strikes the language June 30, 2008 and inserts the language December 31, 2009. President Bush has promised to veto the bill if it compromises the Medicare Advantage programs he created early in his first term. While the 69 yea votes on this cloture motion would suffice to override a veto, it is unclear if the senators who changed their votes from nay on June 26, 2008 to yea on July 9, 2008 would continue to vote yea. The House appeared to have a veto-proof majority of 355-59 when it passed the bill in June. [Answer submitted on Jul 9, 2008 7:14 PM]

A5: The bill would provide an additional 18 months of fee cap exemption, extending to December 31, 2009. Although the cloture motion passed 69-30 on July 9th, 2008, the bill still needs to be debated, then voted upon. If it passes, the bill goes to the President for signature or veto. The President has indicated a veto is likely if the additional money for Medicare Advantage plans is redirected to pay for the continuation of Medicare Part B fees without the 10.6% reduction. Congressional override of such a veto is uncertain, based on recent votes. [Answer submitted on Jul 9, 2008 7:23 PM]

A6: Did they pass an 18 month extension? [Answer submitted on Jul 9, 2008 7:55 PM]

A7: The bill did pass. Prior to the vote the Senate agreed that the cloture vote would also be a vote on final passage. The bill goes to president. [Answer submitted on Jul 9, 2008 9:50 PM]

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A1: H.R.6331, as passed by the House, cancels the July 1st cut of 10.6% to physicians fees. For the remainder of calendar year 2008, the fees would continue as they have been for the first 6 months--a 0.5% increase from calendar year 2007. For calendar year 2009, the fee schedule increases by 1.1%. [Answer submitted on Jul 10, 2008 1:03 PM]

A2: It is in the current bill. The new bill states that the 10.7 cut won't take affect. The rates would stay the same for the whole year and the 1.1 increase would take affect in 2009. [Answer submitted on Jul 10, 2008 1:47 PM]

A3: No the bill was already passed in the House by 2/3 majority therefore makes it a "veto" proof bill. [Answer submitted on Jul 10, 2008 2:56 PM]

A4: Such language was included, yes. [Answer submitted on Jul 10, 2008 9:19 AM]

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A1: Not for now. If the president signs it. The cuts were pushed off for yet another year. however there are still no payments being released by CMS until after July 15th. [Answer submitted on Jul 11, 2008 10:33 AM]

A2: The medical education payments to Medicare Advantage plans would be 'phased out' [Answer submitted on Jul 11, 2008 10:48 AM]

A3: No. The program savings achieved by the deeming provisions would not result from payment cuts. Rather, by applying a consistent set of networking and contracting rules across all plans, the current rapid rate of enrollment growth in private fee-for-service plans will be reduced in non-rural areas where other Medicare Advantage plan choices are available. [Answer submitted on Jul 11, 2008 11:23 AM]

A4: Yes it does. It starts to reduce payments in 2010, cutting back some 13 billion in subsidy over 4 years. [Answer submitted on Jul 11, 2008 1:09 PM]

A5: I believe section 161 of the bill. [Answer submitted on Jul 11, 2008 1:20 PM]

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A1: No, accreditation is still mandatory. [Answer submitted on Jul 11, 2008 12:12 AM]

A2: Accreditation is separate from competitive bidding. Still mandatory. [Answer submitted on Jul 11, 2008 11:52 AM]

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A1: In all honesty, most reputable firms have done away with outbound telemarketing. As a marketing provider for several MA/MA-PD providers, we are using education and good old fashioned direct mail to get interested people to call us. [Answer submitted on Jul 14, 2008 10:50 AM]

A2: With the new bill also old fashioned direct mail is not allowed, the only thing you can do is through the internet or some form of Radio and TV commercials which the small guys don't have budget for it. [Answer submitted on Jul 15, 2008 7:39 PM]

A3: Answer A2 is incorrect, direct mail will be allowed. its is the follow up calls to the direct mail drop that will not be allowed. Direct mail can bring in prospective members, but the call to a direct mail is what tied the mail piece to the plan and now the plans or providers will have to depend on their mail drops alone for calls [Answer submitted on Aug 8, 2008 12:54 PM]

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A1: Claims are processing on the originally published 2008 fee structure and with the PT CAP in place with no exemptions except for hospital. President vetoed bill today. Until overridden, CAP in place and reduced fee structure in place. [Answer submitted on Jul 15, 2008 6:58 PM]

A2: No. [Answer submitted on Jul 15, 2008 8:05 PM]

A3: The bill is now law and Medicare payments should be processed with the 0.5% update for 2008 and the 1.1% update for 2009 [Answer submitted on Jul 15, 2008 9:38 PM]

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A1: As far as I can read, nowhere in this bill (HR 6331) is the mention of rights or services for illegal immigrants. It simply does not address the issue. [Answer submitted on Jul 18, 2008 9:29 AM]

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A1: No all this does is offset some of the additional revenue these plans receive because of purported extra benefits. Most use elicit marketing tactics to enroll patients such as offering free meals, etc. According to studies they do not offer any extra benefits that what traditional Medicare offers yet they are reimbursed upwards of a $1000 dollars per patient per year above traditional fee for service medicare. [Answer submitted on Jul 16, 2008 8:50 AM]

A2: Not at all! MA plans are extremely profitable. Google the 3 largest MA carrier and read their statement from last year - they made billions in profit! How Bush can justify cutting physician fees to line MA pockets is beyond me (i.e. lobbying, donation, kickback, etc.). What Bush insists as "choice" really means privatization of Medicare, and ultimately more wealth for the wealthy! Put MA out of business? Not a chance. They'll just be more efficient (i.e. cut more corners) to make up the difference. This is personal knowledge as I used to work for the 2nd largest MA plan. [Answer submitted on Jul 16, 2008 12:17 PM]

A3: To A1: Actually most Medicare Advantage plans DO provide extra benefits, such as drugs, vision and dental care, and physicals, which are not traditionally covered by Medicare. Also, Medicare Advantage plans usually cost recipients less annually than regular Medicare, in many cases less than half. [Answer submitted on Jul 16, 2008 3:25 PM]

A4: To A1. As an agent who has given hundreds of seminars for MA plans, and I can assure you that no one has purchased a PFFS plan from me because of a free meal. With that said, I am pleased that the offering of free meals has been removed as a marketing practice because now only people interested in what the plan has to offer will come to a seminar, and not just for the free meal.

As for extra benefits, most plans do offer extra benefits beyond what original Medicare has to offer. My biggest concern about this bill is for the many rural area Medicare beneficaries who love their MA plans because of the money it saves them. When the insurance companies change these plans by lowering the benefits offered, (and they will)thousands of people in my area alone will be forced to buy a supplement, if they can afford it, or go back to original Medicare, and once again incur high out of pocket expenses. In my opinion it is a shame that they could not find a way to stop the physician's reduction and give them a pay increase, without compromising the health care of so many of our senior citizens. [Answer submitted on Jul 18, 2008 9:52 AM]

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A1: EHR (Electronic Health Record) will cost every office practitioner between $10,00-$15,000 per month with a Contract of 5-8 years. If Medicare will reimburse the cost of this then it will be useful for providers. Some doctors are prematurely retiring because of this burden of cost. Therefore, a 2% incentive to e-prescribe is a big joke. Try to find out how many physicians who are independently practicing in the US have EHR. Practically zero because the cost and maintenance/service is highly prohibitive. [Answer submitted on Jul 16, 2008 3:20 PM]

A2: That's ridiculous. If implemented properly, EMRs can SAVE practitioners more than 200% of the cost of implementation. I've worked with EMRs and providers for years and never seen a cost of $10K/month unless it's a huge operation. Most providers don't know how to use EMRs to their benefit. eRX services will only save the providers cost for the effort of writing Rxs and alleviate them from the risk of malpractice. [Answer submitted on Jul 16, 2008 10:48 PM]

A3: How exactly does EMR decrease overhead? In the systems I have seen, documentation of an encounter takes longer.For a solo practitioner, record retrieval is not an issue. [Answer submitted on Aug 4, 2008 11:22 AM]

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A1: The 2% is is for quality reporting which is PQRI. [Answer submitted on Jul 18, 2008 7:36 AM]

A2: From the AMNews article concerning e-prescribing: "Under the Medicare payment bill that became law in July, doctors who prescribe electronically for Part D patients in 2009 will get an incentive payment equal to 2% of all the Medicare services they provide for the year."

www.amednews.com/2008/gvl10804 [Answer submitted on Jul 28, 2008 5:37 PM]

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A1: From an AMNews article: "The Centers for Medicare & Medicaid Services will issue rules later this year that will determine exactly how the incentive system will work and when bonuses will be paid."

http://www.ama-assn.org/amednews/2008/08/04/gvl10804.htm [Answer submitted on Jul 28, 2008 5:40 PM]

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A1: Yes, commissions will be lowered to offset the reduction of payments from medicare to the ma companies. [Answer submitted on Sep 16, 2008 11:53 PM]

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A1: No, should not eliminate brokers. [Answer submitted on Sep 16, 2008 11:54 PM]

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A1: None. Currently only one certified tech is required per shift. See ACR accreditation requirements. Plus, this only for SOME OUTPATIENT facilities only. Not hospitals and not all outpatient facilities. [Answer submitted on Mar 25, 2009 7:59 AM]

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