July 16, 2008 — The Medicare Improvements for Patients and Providers Act (HR 6331) — which delays cuts in reimbursements to physicians treating Medicare beneficiaries and military personnel and phases out higher copayments for mental illness — became law yesterday after Congress voted to override President Bush's veto.
The president issued the veto in the morning, stating that the bill was "objectionable" because it would take funds from private health insurers to keep paying physicians, and this would be "fiscally irresponsible."
But within hours the House voted 383 to 41 to overrule him, and the Senate soon followed in a 70-to-26 vote.
Long and Winding Road
"It has been a long and winding road, but today we celebrate that Congress heard the voices of millions of patients and physicians and voted to override President Bush’s veto and protect the health of America," Nancy H. Nielsen, MD, president of the American Medical Association (AMA), said in a statement issued to the press.
The scheduled cut in payments to physicians who treat Medicare patients would have been devastating to seniors and the disabled, who rely on Medicare for their healthcare needs, and for military families, who rely on TRICARE for healthcare needs, she added.
"Along with the AMA, many patient, physician, and military groups called on Congress to pass this bipartisan bill. The only group opposing the bill was the health insurance lobby, which was eager to protect health plan subsidies and profits. Seniors, the disabled, and military families celebrate with us today as this bill becomes law to protect their access to needed healthcare," she said.
The bill — which halts a scheduled 10.6% cut in payments to physicians who treat Medicare patients, institutes a 1.1% payment increase in 2009, and includes legislation to make coverage of mental illness more equitable — was passed by the House on June 25 by a vote of 355 to 59.
On July 9, Sen Edward M. Kennedy made a dramatic, surprise return to the Senate — his first appearance there since his brain cancer was discovered in late May — to break a Republican filibuster on the bill. The Senate passed the bill by a vote of 69 to 30.
Three Notable Changes in Coverage of Mental Health Services
Following the presidential veto yesterday morning, the American Psychiatric Association (APA), along with the AMA, had urged Congress to override it.
In a press release, the APA pointed out that the bill includes several "sweeping and historic changes" to the way Medicare covers mental-health services.
First, Section 102 of the bill "ends the blatant inequality in [copayment] required for all mental-health services under Medicare Part B," the APA stated. For more than 40 years, Medicare required 50% copayment for outpatient psychiatric care, while all other Part B services required a 20% copayment. The new bill will ensure that starting in 2014, copayment for mental health services is the same 20% as for all other Part B services, it noted.
Second, Section 175 of the bill provides coverage of benzodiazepines and barbiturates, drugs commonly and safely used to manage psychiatric and other health conditions, under Medicare Part D. "Without clinical justification, these medications were specifically excluded from the Medicare drug program," the APA added.
Third, the bill provides for codification for 6 classes of medication of clinical concern, so that all or substantially all of certain types of medications commonly used for the treatment of medically vulnerable populations will be available under Part D. "The APA strongly supports the codification of this policy into law," the press release stated.
The bill "fixes significant problems in the Medicare program," APA president Nada Stotland, MD, said earlier. "This bill will allow patients easier access to psychiatrists and treatments that can relieve suffering and help patients live more fulfilling and productive lives," she added.
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作者:admin@医学,生命科学 2011-09-01 05:15