Medicare

Republicans immediately shot back Friday against Senate Democrats' call to keep Medicare reforms out of debt-ceiling talks. 

Sens. Tom Harkin (D-Iowa) and Jack Reed (D-R.I.) took the stance during a conference call with reporters as the Senate prepares to return to work next week.

"Do I believe that Medicare should be off the table?" Harkin said during the call. "You bet I do, because it has nothing to do with the default crisis." 

In a blast email, House Majority Leader Eric Cantor's (R-Va.) office wrote that "Senate Dems Push Medicare Closer To Bankruptcy."

"Even President Obama has said that Medicare needs to be addressed, but Senate Democrats apparently would prefer to stick to their do-nothing ways," the missive says. "The House Republicans’ plan remains the only solution to save and strengthen Medicare for future generations."

Sen. Orrin Hatch (Utah), the top Republican on the Senate Finance panel, said much the same thing.

"What is it the Washington Democrats don't understand?" Hatch said in a statement. "Medicare is the leading contributor to our nation's debt, and any attempt to confront this crisis in a meaningful way must include this broken entitlement program. If we are to ensure that Medicare isn't another broken Washington promise to our seniors then we have to discuss ways of fixing this program." 

Medicare data will become publicly available in an attempt to measure the quality of care that doctors and hospitals provide.

The Centers for Medicare and Medicaid Services (CMS) announced new rules Friday that will give certain organizations access to Medicare data. Private insurance companies sometimes make quality assessments based on their own claims data, but Medicare is by far the largest payer in the U.S. healthcare system. Its claims data can therefore help make quality measurements more accurate, CMS said.

“Qualified” organizations will be able to combine Medicare data with private records, CMS said. Organizations cannot receive Medicare data unless they also have access to private records with which to combine it. And they have to share their findings with providers before releasing them publicly, which CMS said will help avoid mistakes.

Personal information about specific patients will be stripped from the Medicare records.

Republican attempts to tie Medicare reforms to a debt-ceiling increase are "absolutely irresponsible," Sen. Jack Reed (D-R.I.) said.

Republicans know they must improve their Medicare message, but are split on how to do it. 

Small medical practices warned Congress on Thursday that health information technology risks being less than useless if it's designed to meet bureaucrats' arbitrary standards rather than the needs of doctors and patients.

Testifying at a House Small Business healthcare subcommittee hearing, the CEO of HIT Services company Ingenix said cost isn't the main reason physician's offices are struggling to make the switch to paperless. Rather, Andy Slavitt testified, the "purchase and design of technology (…) have taken a back burner to all of the compliance reporting requirements" needed to qualify for federal incentive payments.

"Today," Slavitt said in written testimony, "the end-users, doctors and patients, are further away than ever from system design, because new product development is focused on satisfying those regulatory hurdles, rather than on simple innovations that improve productivity." Read more...

Demagoguery: Rep. Paul Ryan and President Obama went toe-to-toe on Wednesday over Democrats’ attacks against Ryan’s Medicare proposal — yet another escalation in a battle that shows no signs of abating.

Ryan accused the president of demagoguery and said the White House is simply trying to scare seniors by referring to his proposal as a “voucher” plan. The Hill’s Russell Berman has the full story on the House GOP’s “frank” exchange with Obama.

Although Obama reportedly suggested during the meeting that both sides have engaged in some level of demagoguery when describing each other’s healthcare proposals, White House press secretary Jay Carney told reporters afterward that the administration will be sticking to its “voucher” description. Read The Hill’s story.

A CNN poll released Wednesday found that a majority of the country opposes Ryan’s plan, and less than 50 percent think it’s good for Republicans to control the House — though the GOP still does better than Democrats on that score.

More polling: The liberal Herndon Alliance found in its polling that the GOP Medicare plan has not only turned people against the GOP, it has increased the popularity of Democrats’ new healthcare law. Approval for healthcare reform has risen, and disapproval has dropped, since Ryan’s budget took over the political discussion about healthcare, the poll found. Healthwatch’s Julian Pecquet has the story.

Something similar happened during the debate over the healthcare law: as it reached the height of its unpopularity, polls also started to show an uptick in how happy people were with their existing coverage.

Medicaid: With all the focus on Medicare, some advocates and liberal Democrats have started to worry that Medicaid might end up on the chopping block as Congress looks for some kind of healthcare cuts. Sen. Robert Menendez (D-N.J.) told reporters that’s not going to happen. Healthwatch’s Sam Baker has more.

Abortion: The Obama administration said Wednesday that Indiana doesn’t actually have the power to cut off federal funding to Planned Parenthood, as a new law in the state attempts to do. The Health and Human Services Department told Indiana’s Medicaid office that it can’t cut off specific providers based solely the services they provide.

The Susan B. Anthony List sharply criticized the administration’s response. “Secretary Sebelius is strong-arming states like Indiana to protect the Administration’s powerful ally Planned Parenthood,” the group said in a statement.

The Institute of Medicine said Wednesday that Congress and the administration should standardize the labor markets and the wage and benefits indexes it uses when adjusting Medicare payments for hospitals and physicians based on local costs.

The IOM recommendations are the first of two reports on geographic adjustments required by the healthcare reform law. More than 30 House Democrats from the Midwest and Pacific Northwest demanded a review of the way Medicare adjusts payments for providers because of concerns that providers in their districts are getting stiffed.

Wednesday's report makes several recommendations:

• Medicare should use the same labor market definition - metropolitan statistical areas - when determining adjustments for hospitals and physicians;

• The wage index should be based on data from the Bureau of Labor Statistics, which will require changing the law; and

• Data from all occupations in the healthcare workforce should factor into the adjustments.

The top Republican and Democrat on the Energy and Commerce Health panel are pushing back against proposals to curb medical imaging tests paid by Medicare, arguing that they could restrict access to "life-saving medical tools."

In a letter to the chairman of the Medicare Payment Advisory Commission (MedPAC), Reps. Joe Pitts (R-Pa.) and Frank Pallone (D-N.J.) request that scheduled imaging payment cuts be allowed to go into effect before new restrictions are considered. In April MedPAC voted to submit clinicians who order large numbers of such tests to prior authorization, a recommendation that's expected to be included in the commission's June report to Congress.

"MedPAC views medical imaging as a major driver of Medicare expenditure growth," the letter to Glenn Hackbarth says. "Today, we must question the validity of that claim."

Separately, the comptroller general on Tuesday announced the appointment of two new MedPAC members and the reappointment of three others. Read more...

Rep. Phil Gingrey says it would be "pretty darn irresponsible" to back away for fear of losing a few seats.

The brazenness with which lawmakers are changing their rhetoric to woo seniors has amazed even longtime Washington hands.