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U.S. Senate Approves AOA-backed Medicare Fee Fix, DMEPOS Accreditation Delay



Updated July 10, 2008

With nine senators deciding to reverse course after a week-long congressional recess, the U.S. Senate finally passed the AOA-backed Medicare Improvement for Patients and Providers Act (H.R. 6331) on July 9th. The bill, backed by AOA and a national coalition of provider and patient groups, would avert massive cuts in Medicare physician reimbursement over the next 18 months and provide positive payment updates through 2009 to be funded through reductions in subsidies to Medicare Advantage plans.

The measure also contains a provision to block implementation of an unfair DMEPOS accreditation regulation that has been strongly opposed by the AOA.

The Senate's action is a key step toward ending months of uncertainty for ODs, MDs and other providers. As key votes in Congress approached, the AOA Washington office issued a series of legislative action alerts — including some directed at attendees at Optometry's Meeting® in Seattle — urging optometrists to contact their senators in support of the legislation. Bolstered by AOA Federal Keypersons Leaders, volunteers and staff from state associations mobilized effectively and helped get optometry's message to Capitol Hill.

In remarks on the Senate floor on June 26, Senator Harry Reid (D-NV), the Majority Leader and key backer of H.R. 6331, specifically recognized AOA as a supporter of the bill.

H.R. 6331 would eliminate the imminent 10.6 percent cut in Medicare payments to doctors and prevent the 5 percent pay cut scheduled to begin Jan. 1, 2009. The bill would also

  • extend the 0.5% positive payment update in effect since January through December 31, 2008
  • provide a positive update of 1.1% for 2009
  • block implementation of a proposed DMEPOS accreditation regulation, which would be overly burdensome on optometry

The key Senate vote was 69 to 30 to end a Republican-led filibuster, with decisive votes cast by Senator Edward Kennedy (D-Mass.), returning to the Senate for the first time since he began treatment for a brain tumor, and a group of Republican senators identified by AOA and other groups as potential supporters of the bill.

In the end, nine Republican senators

  • Mel Martinez of Florida
  • Saxby Chambliss and Johnny Isakson of Georgia
  • Arlen Specter of Pennsylvania
  • Lamar Alexander and Bob Corker of Tennessee
  • Kay Bailey Hutchison and John Cornyn of Texas
  • John Warner of Virginia

changed previous "NO" votes to "YES" votes after hearing from ODs and other providers from their home states during Congress's week-long 'Fourth of July' recess.

Last month, H.R. 6331 overwhelmingly cleared the U.S. House by a vote of 355 to 59. However, the White House and some Senate Republicans opposed the bill, in part because of its payment reductions to Medicare managed care plans.

President Bush has vowed to veto H.R. 6331, though as of July 10, the White House had not made a formal announcement. The AOA Washington office notes that the Senate and House margins indicate that there is sufficient support for a veto to be overridden. Nevertheless, on behalf of ODs and their patients, the AOA has called on the President to sign the bill without any delay.

The July 9 Senate victory was a remarkable turnaround from the devastating single vote defeat on June 26th. However, the week-long national lobbying by the AOA as well as other provider and patient groups was recognized to have made an important difference.

"The Senate vote is a victory for our profession and our patients," said Jerald Combs, O.D., chairman of the AOA Federal Legislative Action and Keyperson Committee. "The AOA Advocacy Group thanks our affiliate leaders, volunteers, members and staff as well as our Federal Keypersons who responded immediately to the Washington office's call-to-arms on H.R. 6331. We had 10 days to gain votes, and we did it."

The AOA Federal Keyperson Program — optometry's grassroots network of doctor advocates — was activated through urgent alerts from the Washington office. Keypersons, AOA volunteers and concerned ODs and students from across the country all got involved and called the Capitol Hill switchboard asking to be connected to the office of their senators. In addition, working with affiliate leaders in Florida, Georgia, Pennsylvania, Tennessee, Texas, Virginia and other states, the AOA worked to do its part to convert several June 26th "NO" votes into "YES" votes on July 9th.

"Hopefully, with the additional time that passage of H.R. 6331 affords, Congress will begin to work on a long-term solution to the broken Medicare-SGR payment system without having to again resort to a temporary fix", notes Michele Haranin, O.D., chair of the AOA Federal Relations Committee.