House set to approve Medicare contracting overhaul

The House is poised to take up and pass a bill today representing months of bipartisan negotiations between the administration and the often-sparring committees of jurisdiction that would dramatically reform the way the Centers for Medicare and Medicaid Services interacts with providers, contractors and beneficiaries.

"This is a fundamental first step to modernizing the Medicare program," said a Republican aide involved in the drafting of the bill at a briefing for reporters Monday.

However, the bill could fall by the wayside this year as it appears nowhere on the Senate's horizon.

Senate Finance Chairman Baucus and ranking member Charles Grassley, R-Iowa, introduced a similar measure last week, but its fate is unclear. Baucus has not scheduled a markup, and his office indicated the committee's schedule is too full to add another item.

"I think it's just the tight schedule.... Our priorities are the economic stimulus," a committee spokesman said.

A House Democratic aide suggested that the Senate may face more problems in bringing a bill up for a vote than the House because of the prerogative senators have to offer numerous amendments.

But House aides hope that swift passage in that chamber might put pressure on the Senate. "This is a nice thing to get off the decks," said one Republican Ways and Means Committee aide.

The House bill, reflecting agreement by both Republicans and Democrats on the Energy and Commerce and Ways and Means committees, is expected to be included on the suspension calendar today.

The bill would improve the predictability of regulations and increase CMS' flexibility in crafting contracting requirements.

It also would improve the education of enrollees and providers on what services are covered before they are rendered; streamline the appeals process; narrow the definition of extrapolation for use by CMS and give providers new appeals rights; ensure CMS and FDA share information on new technologies; require studies on payment systems and improvements to emergency room treatment; and authorize civil money penalties on hospitals which do not comply with blood borne pathogen requirements.

It also contains time-sensitive Medicare+Choice provisions that could get moved to another bill in order to get them passed.

The provisions would codify what the administration has already done by executive order.

House members would prefer keeping them together with the reform bill. "We're supporting the bill in its entirety right now," said a Republican House Energy and Commerce Committee aide.