Washington Committee: Hot Topics

August 2, 2007

House Passes CHAMP Bill 225 to 204

House of Representatives Passes Legislation to Prevent Medicare Physician Payment Cuts – Neurosurgeons Should Contact Your Representatives About this Vote

On August 2, 2007, the U. S. House of Representatives passed H.R. 3162, the Children’s Health Access and Medicare Protection (CHAMP) Act of 2007, by a vote of 225 to 204. The bill, which was supported by the AANS and CNS, would reauthorize the State Children's Health Insurance Program (SCHIP) and contains the following key provisions related to Medicare:

• Replaces the total 15 percent physician payment cut in 2008 and 2009 with a .5 percent increase in each of these two years. The $20 billion spent on this provision represents a 16 percent total net increase in reimbursement.
• Repeals the flawed sustainable growth rate (SGR) formula, replacing it with a system based on 6 separate service specific expenditure targets, including major surgery (10 and 90 day global services), primary and preventive care, other E&M services, imaging, minor and other procedures and anesthesia. Surgeons should be better off under this system.
• Eliminates funding for the Medicare Physician Quality Reporting Initiative (PQRI), which may do little to actually improve quality.
• Removes drugs furnished incident to a physician service from the payment formula in 2010. Including such expenditures in the annual physician growth target has exacerbated the scope of the payment cuts and the AANS and CNS have long advocated for this change.

Unfortunately, the bill is not perfect and there are several provisions organized medicine will be working to improve as the legislative process moves forward. For example, because the physician spending package had to be scaled back from $30 to $20 billion, physicians still face Medicare cuts of approximately 11 percent in 2010 and 2011.

For those interested in the details of the CHAMP bill, you can peruse the Ways and Means Committee’s legislative report at http://waysandmeans.house.gov/media/pdf/110/8-1Reports/3162report.pdf. This document includes the bill text, explanatory provisions, and other information.

Outlook
The fate of this legislation remains uncertain as the Senate-passed SCHIP legislation did not contain any Medicare provisions and includes a children’s health package that is less-generous than the House-passed bill. Significant differences will therefore need to be worked out in a House-Senate conference. Furthermore, the threat of a presidential veto looms large given the cost and scope of the House legislation. The AANS and CNS will continue to work with lawmakers and other physician groups to achieve the best possible outcome for neurosurgeons.

Please Contact Congress
To see how your Representative voted and send him/her a letter about this vote go to the AANS/CNS Legislative Action Center at: http://capwiz.com/noc/issues/votes/?votenum=787&chamber=H&congress=1101. Once here simply scroll over your state for the vote information and then enter your zip code to go directly to a sample letter that you can edit and personalize.

If you have any questions about this legislation, please contact Lori Shoaf, Senior Manager for Legislative Affairs, AANS/CNS Washington Office at lshoaf@neurosurgery.org or 202/628-2072.