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A Weekly Publication of the Department of Government Relations  Week of March 15, 2010 
In This Issue
Health Reform in Congress
Senate Passes Bill to Postpone Medicare Payment Cuts
One-Year Extension of 5 Percent Medicare Psychotherapy Payment Bump Included
APA Joins AMA in Letter Urging CMS to Extend Medicare Participation Deadline
HRSA Announces Part-Time Option for National Health Service Corps Personnel

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APAPAC Events
 
3/16 - 5:00 p.m. - Rep. Patrick McHenry (R-NC) Meet & Greet Event
 
3/17 - 5:00 p.m. - Tuesday Group (R)
 
3/18 - 4:00 p.m. - Rep. John Sullivan (R-OK)
 
3/19 - 8:00 a.m. - Rep. Shelley Berkley (D-NV)

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Health Reform in Congress
House and Senate Democrat leaders, in conjunction with the Obama Administration, continue to hammer out details of a final health reform proposal that can be approved by a majority in both chambers. In particular, congressional leadership is weighing the elements of a budget reconciliation package that would make "corrections" to the Senate-passed bill, H.R. 3590, in order to bring it in line with agreed-upon provisions arising from the larger health reform debate. It has been reported that the Congressional Budget Office (CBO) has received draft reconciliation provisions to determine their potential cost, and House Speaker Nancy Pelosi (D-CA) anticipates sending a reconciliation bill to the House Budget Committee for review early next week. President Obama has urged Congress to act on final health reform legislation prior to the Easter recess, only two weeks away. Several key issues must be resolved in order to meet this goal,; both legislatively - whether and how to cover abortion services within the health insurance exchanges, and procedurally - how to enact the Senate-passed bill in order to amend it through the budget reconciliation process, and which provisions qualify to be included as "budgetary" corrections. DGR staff will continue to closely monitor these developments and will bring you updates as the process unfolds.
Senate Passes Bill to Postpone Medicare Payment Cuts
By a vote of 62-36, the Senate approved H.R. 4213, a jobs bill that also postpones the pending 21 percent cut in Medicare payments to October 1, and also extends a small payment increase for psychotherapy services.  The bill now returns to the House where additional amendments may be offered, sending the bill back to the Senate for further consideration. We will keep you updated as this process unfolds.  Once approved by both chambers of Congress, the bill would postpone the scheduled 21 percent cut in the 2010 update to the Medicare payment formula until October 1, 2010.  Congress has already approved several delays in the cut which was otherwise to have gone into effect on January 1.
One-Year Extension of 5 Percent Medicare Psychotherapy Payment Bump Included
In particularly welcome news for APA members, the jobs bill also includes a one-year extension of the temporary 5 percent bump in payment for psychotherapy services.  The payment bump was approved as part of the "MIPPA" bill in 2008, but expired on January 1, 2010.  The 5 percent bump would apply to calendar year 2010 services, and would be retroactive to January 1.  APA has lobbied hard for this extension, which is also included in the Senate-passed health reform bill now pending a House vote.
APA Joins AMA in Letter Urging CMS to Extend Medicare Participation Deadline
APA joined AMA in writing to the Centers for Medicare and Medicaid Services (CMS) to request that they extend the deadline for physicians to change their Medicare participation or non-participation status from March 17, 2010 to April 16, 2010.  The letter stated; without some degree of certainty about Medicare payment rates, physicians simply cannot make informed decisions about their contractual relationships with the Medicare program.  Congress recently passed legislation extending the 2009 Medicare physician conversion factor through March 31, 2010.  However, unless Congress intervenes on April 1, Medicare payments to physicians will be cut by 21 percent. The letter also underscored how patients and physician practices continue to be hurt by the ongoing instability of the Medicare system, and the vicious cycle of short-term delays makes Medicare practice decisions difficult.
HRSA Announces Part-Time Option for National Health Service Corps Personnel
In March 2010, clinicians working part-time (20 to 39 hours each week, at least 45 weeks each year) at NHSC-approved facilities will be eligible to apply to the National Health Service Corps demonstration program for the Part-time Loan Repayment. The criteria for the Part-Time Demonstration Program will be comparable to the current NHSC Loan Repayment Program. Below are some specifics about the program:
  • Four-year service commitment for $50,000
  • Potential for additional years of support - two-year service contract
  • Application Period open for 30 days
  • 400 awards Anticipated
  • Same eligible disciplines as full-time Loan Repayment Program