Medicare Compliance & Reimbursement

The proposals to "fix" Medicare's funding shortfalls have only just begun.

On Feb. 25, Congress introduced legislation that includes proposals on how to curb Medicare spending. Titled the "Medicare Funding Warning Response Act of 2008," the legislation is known among industry insiders as a "trigger" bill, and suggests several ways to cut spending in the Medicare program.

"Left unchanged, within 35 years Medicare would eat up every bit of the federal budget as we now know it," said HHS Secretary Michael O. Leavitt during a press call last week.

The following is a sampling of suggestions that the trigger bill offers to curb Medicare spending:

• Develop and implement a system for encouraging nationwide adoption and use of electronic health records and make personal health records available to Medicare beneficiaries.

• Provide price and cost information to Medicare beneficiaries to assist them in making choices among providers, plans and treatment options.

• Implement incentives for Medicare beneficiaries to use more efficient providers and preventive services known to reduce costs.

• Increase the beneficiary premium for prescription drug coverage for single beneficiaries with incomes greater than $82,000 and married beneficiaries with incomes greater than $164,000.

Although the new trigger bill doesn't mention the other cuts that the White House has proposed to fund its Medicare savings (such as halting the ASC, SNF and hospice updates), leaders in those industries are still concerned about what may be coming down the pike.

"Many hospice programs operate on a narrow margin, and the proposed budget cuts will certainly threaten their viability," says Gail Austin Cooney, MD, FAAHPM, medical director with Hospice of Palm Beach County in Palm Beach County, FL and president-elect of the American Academy of Hospice and Palliative Medicine. "Drug costs are rising annually, along with salaries for critical care providers, such as nurses. I am especially concerned that patient access will be restricted because of the budget cuts."

To read the Medicare Funding Warning Response Act of 2008 in its entirety, visit http://www.finance.senate.gov/sitepages/legislation.htm.