Fate of Medicare pay raise hinges on contentious SCHIP negotiations

Senators may move to strip the Medicare physician reimbursement increase out of the children's health legislation.

By David Glendinning, AMNews staff. Aug. 20, 2007.

Washington -- Just before leaving Washington for their August break, House lawmakers passed a measure that would prevent Medicare physician pay cuts for the next two years. But final approval is far from certain.

The move is part of legislation to reauthorize and expand the State Children's Health Insurance Program. The Children's Health and Medicare Protection Act of 2007, passed by the House on Aug. 1, would turn the 9.9% and 5% Medicare payment reductions expected in 2008 and 2009 into 0.5% increases for each year.

The next day the Senate passed the Children's Health Insurance Program Reauthorization Act of 2007, which would renew and boost SCHIP but not change Medicare physician pay.

When Congress reconvenes in September, a conference committee will try to craft a compromise between the two substantially different bills. Because SCHIP will expire Sept. 30 without congressional intervention, lawmakers are under a tight timetable.

"America's doctors urge Congress to expedite the conference process," said American Medical Association Board of Trustees Chair Edward L. Langston, MD. "Working together, we are confident that members of Congress from both chambers and both sides of the aisle can find common ground so that children and seniors will continue to have access to needed health care services."

But survival of the Medicare physician piece in the House legislation is not a sure thing, say Senate leadership aides. Key Republican senators are seeking assurances that the conference committee will not broaden the scope of the Senate measure in crafting a final bill. If negotiators agree, this would necessitate jettisoning the physician pay boost and other Medicare provisions in the House bill and trying to pass them separately.