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Congress to former CMS chiefs: How would you fix Medicare?

Baucus asks four former Medicare administrators for plan to 'fix' the program

Topics: Medicare, Reimbursement, Finance, Health Policy, Market Trends, Strategy, Payer and Regulatory Policy, Recession/Downturn

May 14, 2012

Four former CMS administrators have one month to develop a plan to overhaul the widely panned Medicare physician payment system.  

The ex-agency heads—Gail Wilensky (who led CMS from 1990 to 1992), Bruce Vladeck (1993-1997), Thomas Scully (2001-2003), and Mark McClellan (2004-2006)—were attending a hearing last week to discuss the sustainable growth-rate (SGR) formula. The SGR is scheduled to cut physician reimbursement rates by 30.9% in January.

At the request of Senate Finance Committee chair Max Baucus (D-Mont.), the four former heads will work to create short-term and long-term SGR "fixes." Baucus notes that the request does not represent a commitment to introduce the officials' proposals as legislation.

Following the hearing, the administrators expressed cautious optimism that they could reach a solution. McClellan—who now is a senior fellow at the Brookings Institution—said the recent progress on FDA user fee reauthorization legislation suggests the possibility of similar bipartisan agreement on Medicare payments.

However, Wilensky—who now works as a senior fellow at Project Hope—said that looming payment cuts will limit the four administrators' short-term options. "The question I'll have to think hard about is whether there is anything we can come up with other than payfors" for the short-term fix, he said (Daly, Modern Healthcare, 5/10 [subscription required]; Kaiser Health News, 5/10).

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