Tag Archives for Max Richtman

“Doc Fix” Law Brings Permanent Changes to Medicare Physician Payments

Published in Woonsocket Call on April 19, 2015

Congress put aside its fierce partisan bickering and came together to pass H.R. 2 – the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This week President Obama took the opportunity to sign the legislation package into law.

The Congressional fix repeals and replaces the flawed Medicare physician reimbursement system known as the sustainable growth rate or Sustainable Growth Rate (SGR). For the past 13 years, physicians have faced the possibility of an arbitrary cut in their Medicare payments unless Congressional lawmakers passed a so-called “Doc.fix” Medicare bill. Since 2003, Congress has passed 17 short-term bills to block these cuts in Medicare doctors’ fees that were called for under the existing law.

On April 14, the U.S. Senate passed the MACRA by a whopping 92 to 8 (the House passing its version of the bill in late March by a large margin, 392-37). Two days later, at an outdoor signing ceremony in the Rose Garden, President Obama signed the legislation into law, with the House bill brokers, Speaker John Boehner (R-Ohio) and House Minority Leader Nancy Pelosi (D-Calif.) in attendance. .

A Permanent Fix Prevents Payment Cuts

Just hours before a cut in reimbursement that would take place this week, a rare bipartisan Congressional effort prevented a 21 percent cut in Medicare payments to occur. It’s a permanent fix. And the new law extends the Children’s Health Insurance Program, which has provided coverage to millions of American children.

At the signing, Obama called the passage “a milestone for physicians, and for the seniors and people with disabilities who rely on Medicare for their health care needs,” noting that it would also strengthen the nation’s health care delivery system for the long run.

Obama stated this new law “creates incentives to encourage physicians to participate in new, innovative payment models that could further reduce the growth in Medicare spending while preserving access to care.”

According to the Center for Medicare Advocacy (CMA), a national nonprofit, nonpartisan law group that provides education, advocacy and legal assistance to older people and people with disabilities, the estimated cost of the new law is roughly $214 billion over 10 years. CMA says roughly half (approximately $35 of the total $70 billion over 10 years) will come from Medicare beneficiaries through changes that will increase their out-of-pocket costs for health care.(through means testing of higher-income Medicare beneficiaries, increased Part B premiums, and added deductibles to Medigap plans purchased in the future.”

CMA adds that the nation’s pharmaceutical and insurance industries were not required to pay for any of this law, although doing so would have paid for a major portion of the SGR replacement.

On the Back of Medicare Beneficiaries

Aging advocacy groups, including the Center for Medicare Advocacy and AARP, failed in their attempts to improve the Senate bill Medicare beneficiaries, including a repeal of the annual therapy caps, raising eligibility standards for low-income programs and permanently extending outreach and education funding for critical programs aimed at low-income beneficiaries. The Senate bill passed without amendments.

While many gave thumbs up to the new law, Max Richtman, President and CEO of the Washington, DC –based National Committee to Preserve Medicare and Medicaid, sees big problems with MACRA. “The Senate ‘Doc Fix’ vote has traded one bad policy for another, shifting the costs of Congress’ failed Medicare payment formula for physicians to seniors who can least afford to foot that bill. Contrary to claims by supporters, on both sides of the aisle, this ‘doc fix’ will hit millions of seniors who aren’t ‘wealthy’ by any stretch of the imagination. Seniors at all income levels who are already paying steep premiums for Medigap plans to help control their health care costs will now be hit with even higher costs. Forty-six percent of all Medigap policy holders have incomes of $30,000 or less.”

Richtman added, “Medicare beneficiaries will also be forced to contribute nearly $60 billion in premiums over the next decade thanks to passage of this so-called ‘fix.’

It’s no surprise that conservatives applaud this legislation as ‘the first real entitlement reform in two decades’ because it fulfills their political goal of shifting costs to seniors, cutting benefits and expanding means-testing to push Medicare further and further away from being the earned benefit seniors have long valued and depended on.”.

“Trading a bad deal for doctors for a bad deal for seniors is not a legislative victory and it is a surprising move from so many in Congress who have previously vowed to protect Medicare from harmful benefit cuts and seniors from cost-shifting,” says Richtman. .

AARP CEO Jo Ann Jenkins also expressed strong disappointment in the Senate not passing an amendment that would have removed Medicare’s arbitrary cap on physical therapy, speech language pathology, and occupational services. “Many Medicare patients, particularly stroke victims and people with Parkinson’s and Multiple Sclerosis would have benefited,” says Jenkins. With a majority of the Senate agreeing with this amendment, Jenkins says that AARP will continue to lobby to remove the arbitrary coverage cap.

But, Jenkins sees the positives. “Passage of MACRA moves Medicare in the right direction toward better quality health care and greater transparency for patients. These changes will benefit Medicare beneficiaries, as well as physicians and other providers, hospitals, and the overall health care system,” she says.
.
Through the enactment of MACRA Congress put aside its political differences that made a permanent fix to a flawed law. If you can do it once, let’s see our lawmaker do this again, to provide improved programs and services to our nation’s older population.

Herb Weiss, LRI ’12 is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

President’s Budget Addresses Issues of Interest to Seniors

Published in Pawtucket Times on February 27, 2015
President Obama released his 141 page ‘policy and wish list” when he unveiled his politically ambitious FY 2016 budget on Feb 2, not having to worry about running for president in the upcoming 2016 presidential election cycle.

Yes, even inside the Washington Beltway a picture is truly worth a thousand words. Gone is the budget’s plain blue cover replaced by a black and white photo of the Tappan Zee Bridge in New York, an image that projects one of the President’s spending priorities of rebuilding the nation’s infrastructure to create jobs and improve the transportation system.

The $4 trillion presidential budget, a political campaign document outlaying his policies and priorities, would cancel automatic sequestration cuts to domestic and military programs over a 10 year period. According to the New York Times, Obama’s budget proposal would add $6 trillion to the national debt, and the single-year deficit would rise to $687 billion by 2025.

Obama’s FY 2016 budget puts more funding into education, rebuilding the nation’s infrastructure, increased defense spending, along with providing tax relief for America’s middle class while increasing the taxes for corporate America and the wealthy. Political insiders say that Obama’s budget, one that gives to the middle class and assesses higher taxes from corporate America and the wealthy, sets the issues to be surely debated in the upcoming presidential election. .

A Look at Aging Priorities

On her Feb. 3 blog post, Nora Super, executive director of the upcoming White House Conference on Aging, details how the recently released budget proposal will “ensure that older Americans enjoy not only longer but healthier lives.”

As to retirement security, Super notes that the Obama Administration strongly opposes any legislative measures that would privatize the nation’s Social Security program, or slash benefits for future generations or reduce basic benefits to current beneficiaries. Super says that half the nation’s workforce, that’s about 78 million, does not have a retirement savings plan at work. “Fewer than 10 percent of those without plans at work contribute to a plan of their own. The President’s FY 2016 Budget expands retirement opportunities for all Americans to help families save and give them better choices to reach a secure retirement,” she says.

According to Super, Obama’s Budget proposal supports healthy aging by strengthening the Medicare program by “aligning payments with the costs of providing care, along with encouraging health care providers to deliver better care and better outcomes for their patients, and improving access to care for beneficiaries.”

To put the brakes to rising prescription drug costs, Super notes that the President’s Budget proposes to close the Medicare Part D donut hole for brand drugs by 2017, rather than 2020, by increasing discounts from the pharmaceutical industry. The Budget proposal also gives the Secretary of Health and Human Services new authority to negotiate with drug manufacturers on prices for high cost drugs and biologics covered under the Part D program.

Linking nutrition to healthy aging, Super says that Obama’s Budget provides “over $874 million for Nutrition Services programs, a $60 million increase over the 2015 enacted level, allowing States to provide 208 million meals to over 2 million older Americans nation-wide, helping to halt the decline in service levels for the first time since 2010.” Also, Obama’s budget ratchets up funding for supportive housing for very low-income elderly households, including frail elderly, to give these individuals access to human services, she adds. .

Protecting older persons from elder abuse, neglect and financial exploitation, Super blogs that the President’s budget proposal includes $25 million in discretionary resources for Elder Justice Act programs authorized under the Affordable Care Act. “Funding will “improve detection and reporting of elder abuse; grants to States to pilot a new reporting system; and funding to support a coordinated Federal research portfolio to better understand and prevent the abuse and exploitation of vulnerable adults,” she says.

Here’s Super’s take on the Obama budgetary blueprint: “Taken together, these and other initiatives in the Budget will help to change the aging landscape in America to reflect new realities and new opportunities for older Americans, and they will support the dignity, independence, and quality of life of older Americans at a time when we’re seeing a huge surge in the number of older adults.”

In a released statement, AARP Executive Vice President Nancy LeaMond gives thumbs to the president’s efforts to “lower the cost of prescription drugs, promote better care, reward improved outcomes and make health care programs more efficient and less wasteful.” She also expresses her nonprofit group’s support for the President’s budgetary priorities to “create opportunities for the middle class” and his goal “to make saving for retirement easier.”

But, LeaMond expresses concerns that higher premiums, deductibles and copays might shift costs to older Americans. “As the federal deficit continues shrinking, we must find responsible solutions for strengthening critical programs and improving the retirement and overall economic security of current and future generations. We must also look for savings throughout the entire health care system, as the rising cost of health care threatens people of all ages,” she says.

In his statement, President/CEO Max Richtman, of the Washington, DC-based National Committee to Preserve Social Security and Medicare, agrees with LeaMond’s concerns of higher premiums, deductible’s and co pays, too. “While some tout increasing means testing in Medicare as a way to insure ‘rich’ seniors pay their share, the truth is, the middle-class will take this hit as well,” he predicts.

Political pundits say that Obama’s 2016 budget was dead-on arrival at Capitol Hill the day it was released at the beginning of February. In the shadow of the upcoming 50th Anniversary of Medicare, Medicaid, and the Older Americans Act, as well as the 80th Anniversary of Social Security, GOP leadership in both chambers of Congress must work with the Democratic President to hammer out a bipartisan compromise. Putting budgetary proposals that strengthens the nation’s programs and services for older Americans on the chopping block for purely political reasons is not acceptable, especially to a nation that opposes political gridlock.

Herb Weiss, LRI ’12, is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

Aging Groups Gear Up to Oppose Cuts in Social Security

Published in Pawtucket Times & Woonsocket
Call, October 18, 2013

Worried Americans woke up to good news yesterday morning. After weeks of political bickering Congress had finally hammered out a political compromise, one that would keep the nation from free-falling off the fiscal cliff.

Over the weeks, Democrats and political pundits had warned that not raising the nation’s debt ceiling by Oct. 17 could lead to the nation’s credit rating being downgraded. If this occurred, average Americans might see higher interest rates for mortgages, car loans, student loans and even credit cards. Higher business expenses, due to expensive borrowing rates, could even force businesses to stop hiring and start laying people off. Housing prices would drop and retail sales slow.

Because of Congressional gridlock, furloughed federal workers, along with the unemployed, would have less money to spend, reinforcing the negative impact on the nation’s economy.

House GOP leadership, catering to its Tea Party allies, led a political impasse between the Democratic-led Senate and President Obama, with demands that the president’s signature “Obamacare” healthcare law be defunded.

But, on the heels of an 11th hour deal, late Wednesday evening, the Senate passed, 81 to 18, a bipartisan temporary fix, supported by a large majority of Senate Republicans, ending the partial federal government shutdown and the threat of default. Hours later, the Tea Party-controlled House conceded to the political reality that any attempt to derail the Senate compromise would have a serious backlash against the GOP brand, passing the measure by 285 to 144.

On day 16 of the closing of the federal government, President Obama with the flick of his pen signed the bill ending the threat of the nation defaulting on paying its bills along with allowing hundreds of thousands of federal workers to return to their jobs.

This agreement raised the U.S. debt ceiling until Feb. 7 and gave the Treasury Department flexibility to temporarily extend its borrowing if Congress does not act before that date. Also, the measure keeps the federal government’s doors open until Jan. 15.

At the end of the Congressional vote, Senator Ted Cruz (R-TX) and his House Tea Party allies saw their efforts fail to delay or to scrap “Obamacare.” However, the GOP Senator did get lawmakers to make a tiny political concession to require the government to verify the eligibility of people receiving federal subsidies under the health care program.

Domestic Entitlements on Chopping Block

Of concern to aging groups, the agreement calls for creating a 12 member House-Senate bipartisan panel that would identify long-term deficit cuts, either overhauling the nation’s tax code or by identifying cuts in entitlement programs like Medicaid, Medicare or Social Security. The panel, led by Budget Committee heads Republican Rep. Paul Ryan of Wisconsin and Democratic Sen. Patty Murray of Washington, is charged with completing its task by December 13, but they are not required to come to an agreement.

“While Washington’s latest self-imposed crisis is over, this is no time to celebrate as another set of random deadlines loom, says Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare, remarking “Here we go again.”

“Yet another committee has been formed in which Social Security and Medicare are the big bargaining chips on Washington’s political poker table, noted Richtman, making it clear for him the “economic security of millions of Americans isn’t a game” .

“And while the vast majority of the American people do not support cutting Social Security and Medicare benefits, the President and some in Congress appear ready to do just that through proposals like the Chained CPI, expanding Medicare means testing to the middle class and raising the retirement age,” warns Richtman.

According to Richtman, President Obama stated “what’s good for the American people” is what should guide this next debate. “Cutting benefits to millions of middle-class Americans who took the biggest hit in the recession clearly does not fit that stated goal,” he says.

In a letter to Congress, Richtman, called for other ways to rein in the nation’s budget huge deficient rather than putting Social Security on the chopping block. Richtman suggests that “instead of cutting benefits, comprehensive reforms in the Affordable Care Act (ACA) that are containing costs in the entire health care sector, including Medicare and Medicaid, ought to be given a chance to work and to be strengthened.”

“Moreover, Social Security does not face an immediate crisis and is not driving either the short-term deficit or long-term debt. We believe Social Security should be strengthened for the long-term by raising the current payroll tax cap on earnings,” adds Richtman.

AARP, the nation’s largest aging advocacy group, was quick to comment on the bipartisan-brokered legislative deal, saying that “AARP is pleased that the President and Congress temporarily averted an economic crisis that threatened our members’ access to Social Security and Medicare, but we are deeply concerned that harmful cuts to these vital programs are on the table for a new round of budget negotiations.”

The statement acknowledges that “some Congressional lawmakers want to trade cuts to Medicare and Social Security benefits to pay for other government spending. Others are calling for cuts to these vital programs to reduce the deficit.” However, according to AARP polls, “the American people, on the other hand, across all ages and party lines, are strongly opposed to cuts to Social Security and Medicare.”

“Whether it is cutting their programs to reduce the deficit or using them as a piggy bank to pay for other government spending, their message to the President and Congress is clear: “Don’t bargain away my Medicare and Social Security benefits,” says the AARP statement.

As the House/Senate Bipartisan Committee begins to organize, AARP is preparing to mobilize its massive membership to block any attempts to slash Social Security bennies or cut Medicare, specifically through a Chained CPI to determine cost of living increases and any reductions in Medicare benefits.

Susan Sweet, a well-known aging advocate clearly sees that a Congressional tinkering with Social Security could severely hit the pocketbooks of older Rhode Islanders. She asks, “Is it too much to ask that seniors, disabled people and veterans not pay the price of huge farm subsidies for agribusiness corporations, disgraceful and unnecessary tax benefits for gargantuan oil companies that are making their biggest profits ever, and wasteful pentagon spending for projects in war zones that are either never built or are soon destroyed?”

She calls on Rhode Island’s Congressional delegation to “stay strong and not compromise on keeping Medicare and Social Security fulfill its promises to seniors, disabled people and veterans by keeping benefits at current levels.”

“Dollars to cut the federal deficit might just come from extra revenues which could be generated from allowing Medicare to negotiate with drug companies and lifting the Social Security payroll tax cap so that wealthy people pay the same rate as middle class and poor people,“ she says.

AARP Gears Up for a Fight

This week AARP launched a series of radio and print ads opposing a Chained CPI Social Security benefit cut and harmful cuts to Medicare in the nonprofit organization’s latest discussion of the nation’s fiscal issues. The print and radio ads target members of the House and Senate in 18 states. The ads follow letters to Congress and the White House, as well as postcards, e-mails and calls to members of Congress opposing a budget deal that would balance the budget on the backs of older Americans.

“Americans have paid into Medicare and Social Security and they’re tired of their hard-earned benefits being used as bargaining chips in another last-minute budget deal,” said AARP Senior Vice President Joyce Rogers. “They deserve responsible solutions that will strengthen Medicare and Social Security now and for future generations, not harmful cuts that will hurt all of us.”

Herb Weiss, LRI ’12, is a Pawtucket-based freelance writer who covers aging, health care and medical issues. His weekly commentaries can be found on his blog, herbweiss.wordpress.com. He can be reached at hweissri@aol.com.