The American Medical Association said today it supports passage of the health care reform bill that the House will vote on Sunday afternoon.

Here’s the full statement from AMA President J. James Rohack, MD.

The pending bill is imperfect, but we cannot let the perfect be the enemy of the good when it comes to something as important as the health of Americans. By extending health coverage to the vast majority of the uninsured, improving competition and choice in the insurance marketplace, promoting prevention and wellness, reducing administrative burdens, and promoting clinical comparative effectiveness research, this bill will help patients and their physicians.

While the final product is certainly not what we would have devised, we strongly support the parts of this bill that are desperately needed by millions of Americans who are struggling to get or keep health insurance coverage. We will continue to work with Congress and the administration to solve important issues that cannot be addressed through the reconciliation process.

This is not the last step, but the next step toward real health system reform. We will remain actively engaged with Congress and the administration to ensure that before Congress adjourns there are additional important changes to our health system. Congress must act to preserve access to care for seniors and military families by permanently repealing the Medicare physician payment formula that will cut Medicare payments by 21 percent next month. According to an AARP poll, nearly 90 percent of people age 50 and older are concerned that the Medicare physician payment cuts threaten their access to care.

Congress must also move immediately to correct problems with the Independent Payment Advisory Board. The current IPAB framework could result in misguided payment cuts that undermine access to care and destabilize health care delivery. The AMA will be relentless in our pursuit of permanent repeal of the Medicare physician payment formula, corrections to IPAB, and other important changes that we outlined in a letter today to House Speaker Nancy Pelosi.

Every day physicians see the devastating effect that being uninsured has on the health of our patients: They live sicker and die younger. Physicians dedicate their lives to helping patients live healthier and longer, and we have an historic opportunity to do just that.

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The Congressional Budget Office says the House’s revisions to the Senate health care bill would result in legislation that cuts  the deficit by $130 billion over the next 10 years, and an additional $62 billion in the 10 years after that.

Here’s the analysis: http://www.cbo.gov/ftpdocs/113xx/doc11355/hr4872.pdf (25 pages)

The House’s second-ranking Democrat said this morning that they’re on track for a vote on the bill no earlier than Sunday.

The full text of the House Rules Committee’s amendments to the Senate bill are available here, along with a  shorter section-by-section summary released by the Speakers’ office.

We’re analyzing their impact and will report back shortly.

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By a voice vote, the House today accepted a proposal from Rep. Sander Levin (D-Mich.) to extend the current physician Medicare payment schedule through April 30.

If the Senate concurs (which is expected), the 21.3 percent payment that’s been hanging over physicians will delayed for another month. It was originally scheduled to take effect Jan. 1.

Why another month’s delay? Congress will begin its Easter recess shortly, probably right after its vote on health reform. That’s not enough time to pass a permanent solution to the payment formula problem – something the AMA, the MMS, and the rest of organized medicine so fervently desire.

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The MMS told the Centers for Medicare and Medicaid Services today that its proposed rules for a national electronic health record incentive program are too aggressive, and would deter  many physicians from participating in the program.

The MMS said the program “asks for too much, too soon” from many physicians, especially those in small practices. Read the MMS letter here. (.pdf, 6 pages)

The comments were a response to the federal government’s proposed  definition of “meaningful use,” the criteria that would determine whether physicians can recoup more than $40,000 of Medicare or Medicaid subsidies per person for installing an EHR. Today was the deadline to submit comments on the widely anticipated rulemaking.

Among the proposal’s shortcomings, according to the MMS:

• Not enough representation from small practices on its advisory committee
• Pediatricians are disadvantaged because few would meet the minimum 20% Medicaid patient panel to qualify
• Specialists are disadvantaged because the criteria are focused on primary care physicians
• The high administrative burden on small practices, who must redesign their workflow to implement an EHR
• Hospital based physicians who also practice in outpatient clinics are unfairly excluded from the program

The MMS recommendations include:

• Lengthen the schedule for adoption and compliance
• Reduce the number of required criteria
• Provide partial reimbursement for partial completion of the criteria
• Create a separate track for those who do not yet have full health IT capabilities

The American Medical Association’s comments today were similar. In a document co-signed by 94 state and specialty medical societies (including the MMS), the AMA said it worries that physicians who install an EHR will find the requirements “overly complex and unattainable.”

The American Hospital Association called for a “rational timeline,” and criticized the lack of clarity in several sections of the proposed rules.

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MMS President Mario Motta, MD, comments on Governor Patrick’s rate regulation proposal in today’s post on Commonhealth, the blog curated by WBUR, calling it “not a wise course of action.”

Instead, Dr. Motta urges the Legislature to pay serious attention to the Health Care Quality and Cost Council’s Roadmap to Cost Containment, which employs a complex approach to the complex problem of rising health costs. Motta doesn’t support all of the Roadmap’s recommendations, but he says it’s a better approach than rate regulation.

Read the entry on the Commonhealth blog here.

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The U.S. Senate today voted to postpone pending Medicare pay cuts to physicians until September 30.

The vote was part of a bill that provides additional Medicaid assistance to the states, and extends COBRA and unemployment benefits for the long-term unemployed.

The bill now goes to the House, which approved an earlier version of the bill.

If enacted, it would give the Congress more time to work on a permanent reform of the Medicare payment formula, key advocacy goal of the AMA, MMS and other physician groups.

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MMS physicians held their first meeting with newly elected Massachusetts Senator Scott Brown on Tuesday afternoon, and the session produced a “good exchange of ideas,” said MMS President Mario Motta, M.D.  The meeting was held as part of the American Medical Association’s National Advocacy Conference, held over three days in Washington.

“It was a very cordial meeting,” Dr. Motta said of the 40-minute session with Brown and his staff. “I think we laid the groundwork for a long-term collaborative effort with him to improve health care. We were able to present our viewpoints on key issues, he listened carefully, and he indicated he wanted to work with us. We look forward to an ongoing dialogue with him, just as we have had with every member of our Congressional delegation.”

Physicians were scheduled to meet with every member of the delegation or their staffs. A meeting with Senator John Kerry was on tap for Wednesday afternoon, and sessions with Representatives Markey, Delahunt, Lynch, McGovern, Neal, Tsongas, Tierney, Olver, and Capuano and their staffs occurred over Tuesday and Wednesday. A previous meeting was held with Congressman Barney Frank in his district.

Some 35 physicians, residents, and medical students from Massachusetts attended the event in Washington.  The National Advocacy Conference gives physicians the opportunity to share their concerns and perspectives on a range of health care issues affecting physicians, patients, and the health care industry. Among the major issues MMS members discussed were the Medicare payment formula for physicians, defensive medicine, and health care reform.

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The March 2010 edition of Physician Focus, the Massachusetts Medical Society’s monthly patient education television program, examines prostate cancer, a disease affecting one in six men and the most common cancer in men other than skin cancer.  Each year, more than 192,000 cases of prostate cancer are diagnosed, and 27,000 men die from the disease.

Host John Fromson, M.D. leads two experts in a discussion describing the causes of the disease, risk factors, how the disease is detected and diagnosed, and the pros and cons of various treatment options.

Guests are  Thomas Kingston, M.D., President of the Massachusetts Association of Practicing Urologists and a physician with Urology Consultants of the North Shore in Salem, and Richard Babayan, M.D., Chief of Urology at Boston Medical Center and Chairman of Urology at Boston University School of Medicine. Physician Focus is distributed to public access television stations across the state and is available online at www.physicianfocus.org with accompanying text and additional sources of information on the topic.

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The Bunning Blockade is over.

The Senate tonight finally passed legislation that temporarily delays a 21 percent Medicare payment cut for physicians, after Sen. Jim Bunning (R-Ky.) ended his controversial one-man fight to block consideration of the bill. The postponement, retroactive to March 1, is set to expire on March 31.

The vote was 78-19.  President Obama is expected to sign the bill without delay. It also extends unemployment benefits for the long-term unemployed and provides stopgap funding for highway projects through March 31.

The AMA continues to work for a permanent reform of the flawed Medicare payment formula.

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Congress has gone home for the weekend, after repeatedly failing to block the 21 percent cut in Medicare physician payment rates set to take effect on Monday, March 1.

Though the House passed the rate freeze, the Senate failed to do so on three occasions. It was attached to a bill that would also extend benefits and health insurance for the unemployed. But Republican Sen. Jim Bunning blocked it each time, saying it wasn’t paid for by cuts elsewhere in the budget.

“It is unacceptable that Congress has failed to protect the health care needs of our nation’s seniors,” said Mario E. Motta, MD, president of the Massachusetts Medical Society. “Both parties agree the payment formula is broken. All we’re asking for is another 30 days to come up with a new solution. We strongly urge the Senate to get back to work immediately to work on the issue, before seniors’ access to care is compromised.”

Dr. Motta also thanked the Massachusetts congressional delegation for its sustained and committed support for permanent reform of Medicare physician payment system.

The Senate may try again next week. There will be no immediate impact on claims processing. The Centers for Medicare and Medicaid Services has told its contractors to hold Medicare physician claims for 10 business days, effective Monday.

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