Don’t Undercut Congressional Power over Medicare, Representatives Say

Thursday, August 6, 2009

WASHINGTON—In a letter to House Speaker Nancy Pelosi,
D-Calif., 75 House members said they don’t think limiting
Congress’ role in setting Medicare policy is a good
idea.

The bipartisan group—45 Democrats and 30
Republicans—told Pelosi they are strongly opposed to setting
up an Independent Medicare Advisory Council as called for by
President Obama or to giving the current Medicare Payment Advisory
Commission more power, a proposal offered up earlier this year by
Sen. John D. Rockefeller IV, D-W. Va. Either proposal would limit
congressional influence on Medicare policy, the representatives
said, including setting reimbursement rates.

“Without the open and transparent legislative process,
Medicare beneficiaries and the range of providers who care for them
would be greatly limited in their ability to help develop and
implement new policies that improve the health care of our nation's
seniors,” according to the July 31 letter.

In addition, the representatives said, if such a provision is
included in health reform legislation, state and community input to
the Medicare program would be limited.

“Geographic and demographic variances that exist in our
nation's health care system and patient populations would be
dangerously disregarded,” the representatives said, as would
Congress’ abilities to work with CMS to create demonstration
and pilot projects.

Last month, President Obama called for the creation of the IMAC,
which would have the authority to set Medicare payment policy and
rates, including for home medical equipment. The new entity would
make recommendations to the President on Medicare payment rates and
other program changes. After approval by the President, the
recommendations would take effect unless Congress blocked
them.

In May, Rockefeller introduced the MedPAC Reform Act of 2009
(S.1110), which would elevate MedPAC to an executive branch agency
with the authority to implement Medicare payment policy. The White
House has said it would be open to that option as well.

Currently, MedPAC is limited to making recommendations to Congress,
which the President said are often ignored and end up
“sitting on a shelf.”

A version of the proposals is reportedly under consideration by the
Senate Finance Committee, which has not yet finalized its health
care reform bill.

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