Still Trying To Mend Medicare

The New York Times reported yesterday that…

Congressional investigators said Tuesday that Medicare had paid tens of millions of dollars to suppliers improperly using identification numbers of doctors who died years ago.

The government has no reliable way to spot claims linked to dead doctors, many of whom are still listed as active Medicare providers though they died 10 or 15 years ago, the Senate Permanent Subcommittee on Investigations said.

And of course, “no one could have predicted” that, right?

Well, this story from last January tells us that Center for Medicare and Medicaid Services director Herb Kuhn (a former lobbyist, of course), enacted a new Medicare competitive bidding program for all manner of medical supplies, with “market rates” used as a basis for accepting bids (which the CMS anticipated to be lower) versus government-established prices.

And “The Bush administration characterizes the program as an attempt to inject market forces into Medicare and reduce federal spending,” according to the January story.

Well, “woo-hoo” for the taxpayer, right?

Not exactly, unless there’s a mechanism to root out the provider fraud that would likely ensue as they try to recover losses due to the lower-costing bids for services (and as this April post tells us, no such mechanism currently exists, nor is one specified in the pending Medicare Fraud Reduction Act sponsored by Mel Martinez, who – need I mention it? – is a Repug).

In spite of this, there actually was good news on this story which occurred yesterday in the midst of the FISA horror, and that was the return of Ted Kennedy to the Senate to break yet another Repug filibuster on pending Medicare legislation; as this story tells us, the following Repugs who voted against the Medicare bill came over to support the re-vote and break the filibuster (good for them for a change).

Lamar Alexander, Saxby Chambliss (I never thought I’d give him credit for anything), Norm Coleman (ditto…he tried to milk the “payment to dead Medicare doctors” issue on Tuesday, of course, and seriously, would he have cast this vote were it not an election year?), Susan Collins (ditto again), Bob Corker, John Cornyn (is that “Big John” video still working its magic, I wonder?), Liddy Dole, Kay Bailey Hutchison, Johnny Isakson, Joe Lieberman, Mel Martinez, Lisa Murkowski, Pat Roberts, Gordon Smith, Olympia Snowe, Arlen Specter, Ted (“The Internet…It’s A Series Of Tubes!”) Stevens, George Voinovich, and John Warner

However, don’t think the typical Repug umbrage and indignation evaporated with Kennedy’s heroic return…

Sen. Mitch McConnell, the Republican Leader, said Republicans should not be blamed for cutting the doctors fees because Democrats won't agree to a short-term fix while they debate a compromise in the Senate.

"Democrats don't want a compromise. They don't want a long term extension of current law. They don't want a short term extension of current law. Yet they're not to blame for this pay cut for Medicare?" McConnell asked rhetorically.

Wow, what “constituent service,” Sen. Mr. Elaine Chao!

As you can read from here (in the “What Could Have Happened Instead Had The Filibuster Not Been Broken” department)…

Kentucky physicians would have lost $190 million for the care of elderly and disabled patients over the 18 months from July 2008 through December 2009 due to a 10.6 percent cut in Medicare payments in July 2008 and an additional 5 percent cut in 2009. On average, each Kentucky physician faced a Medicare cut of $20,000 over this 18-month period. In addition, the state’s physicians would have lost $3.7 billion for the care of elderly and disabled patients by 2016 due to nearly a decade of cuts for this important medical care.

41,528 employees, 655,883 Medicare patients and 159,979 TRICARE patients in Kentucky would have been affected by these cuts.

In July 2008, Kentucky physicians face cuts of an additional 1.8 percent on top of the 10.6 percent cuts across the country. The 2003 Medicare law provided a temporary increase in geographic payment adjustments for certain states. This increase also would have expired on June 30, 2008 under current law.

And one more thing: if you want to fix McConnell for good, click here to get involved.