CLS News Blog

On Tuesday, as expected, President Bush vetoed the Medicare Bill (H.R. 6331) which was passed by the Senate last week by a margin of 69-30. The bill originated in the House and passed there by an overwhelming 355-59 majority.

Just hours after Bush vetoed the legislation, the Senate voted 70-26 to overturn him, following the House of Representatives, which voted 383-41 to override. The bill now becomes law.

See how your Senators and Representatives voted.

Senate

House

Although mostly seen as a big win for physicians, since the bill prevents a 10.6 drop in Medicare reimbursement, this also means that the Competitive Bidding Demonstration Project, which was scheduled to begin earlier this year, and has been on hold since a ruling by a judge this spring, will now be halted. Unknown at this time is what will happen with the sealed bids that CMS had obtained as part of the requried bidding process.

Related articles:

Congress Overrides Bush’s Veto on Medicare – The New York Times

Congress overrides Bush’s Medicare veto – Reuters

In a July 11th article The Hill’s Manu Raju is reporting that even if President Bush vetoes the Medicare bill that the veto is likely to be overridden. Mr. Raju writes:

“President Bush is expected to lose a hard-fought battle with Congress over Medicare legislation as nine key Senate Republicans say they intend to vote to override his veto.

Eight of the GOP senators say they will stand by decisions to switch votes from no to yes when the bill came up this past week. Another senator who voted against the bill says he plans to support the override when the bill comes back after being rejected by Bush.”

This is great news for laboratories as the language to repeal the competitive bidding demonstration project is included in the bill.

Read the entire article here.

Also from The Hill:

Medicare bill nearly law but lobbies stay focused

The White House has confirmed that President Bush is still planning on vetoing the Medicare Bill (H.R. 6331) passed by the Senate yesterday. Although the bill passed in both the House and Senate by more than a 2/3 majority, the Bush Administration is still opposed to the bill.

If President Bush does veto the bill, both the House and Senate believe they have the necessary votes to override the veto.

Read more…

• The Hill
• Lloyd’s

(Updated 4:45 pm MDT) This afternoon the U.S. Senate passed comprehensive Medicare legislation (H.R. 6331) by virtue of a cloture vote 69 to 30. In a surprise appearance, Senator Edward Kennedy returned to the Senatte floor to vote on this measure Senator Kennedy’s surprise appearance and vote made the difference.

The bill is a Medicare package designed to address a scheduled decrease in physician payment rates, as well as other matters. If signed into law by the president, this bill would also repeal the Medicare Competitive Bidding Demonstration Program for Clinical Laboratory Services.

The legislation now goes to the President for either his signature or veto. The Bush Administration has previously threatened to veto the Senate-passed bill, due to its opposition to certain provisions cutting funding for the Medicare Advantage program. If the President vetoes the bill, a two-thirds vote of both the House and Senate would be required to override it.

With the 69-30 vote in the Senate, and the 355-59 vote in the House, it would appear that the bill would have the necessary 2/3 majority to override a presidential veto.

Read more…

• New York Times
• Yahoo News
• Reuters

In the final physician fee schedule regulation published in the Federal Register on November 2, 1999, the Centers for Medicare & Medicaid Services (CMS) stated that it would implement a policy to pay only the hospital for the technical component (TC) of physician pathology services furnished to hospital patients. Prior to this proposal, any independent laboratory could bill the carrier under the physician fee schedule for the TC of physician pathology services for hospital patients. At the request of the industry, to allow independent laboratories and hospitals sufficient time to negotiate arrangements, the implementation of this rule was administratively delayed. Subsequent legislation formalized a moratorium on the implementation of the rule. As such, during this time, the carriers and, more recently, Medicare Administrative Contractors (MAC) have continued to pay for the TC of physician pathology services when an independent laboratory furnishes this service to an inpatient or outpatient of a covered hospital.

The most recent extension of the moratorium was established by the Medicare, Medicaid, and SCHIP Extension Act (MMSEA). Section 104 of the MMSEA expired on June 30, 2008, thus ending the moratorium. Therefore, independent laboratories may no longer bill Medicare for the TC of physician pathology services furnished to patients of a covered hospital, regardless of the beneficiary’s hospitalization status (inpatient or outpatient) on the date that the service was performed. This prohibition is effective for claims with dates of service on and after July 1, 2008.

The office of Senate Majority Leader Harry Reid (D-Nev.) said that the Senate will hold another cloture vote on the House-passed Medicare bill (HR 6331) on Tuesday or Wednesday.

A prior attempt at a cloture vote held on June 26th failed by only one vote. Voting at that time was largely along party lines. Democrats are hoping that an ad campaign by the American Medical Association (AMA) during the 4th of July recess will have put enough pressure on some Republicans to get them to change their votes.

As mentioned previously, HR 6331 passed by an overwhelming majority in the House on June 24th, by a vote of 355-59. At that time, although Senators Baucus and Grassley were reported to be coming to agreement on a compromise between their two Senate versions of a Medicare bill, Mr. Reid decided to proceed with a cloture vote on the House version due to it passing by such a surprising majority.