Senate bill offered to allow young adults to stay on parents' FEHBP; Clock ticks on next round for Medicare physician pay fix

May 14 2010

Government Executive: "This week a senator followed House lawmakers' lead by introducing a bill that would let the children of federal employees remain on their parents' health insurance until age 26, starting this year. Under the health reform law President Obama signed in March, the cutoff age would have increased from 22 to 26 in January 2011 for Federal Employees Health Benefits Program participants, due to laws that prevent the Office of Personnel Management from making midyear changes. The benefit could help more than 2 million federal employees, according to Sen. Ben Cardin, D-Md., sponsor of the Senate bill." The bill would allow a change to the FEHBP plan to allow dependents to stay on their parents coverage beginning this year instead of next (Newell, 5/13).

CongressDaily reports on lawmakers' efforts to again "fix" Medicare physician payments. "Funding for Medicare physician payments has emerged as a sticking point in House-Senate negotiations on a massive package of tax break extensions and aid to states and the unemployed that Democrats want to bring to the House floor next week. Under the statutory pay/go law enacted in February, there is room for $88.5 billion without offsets for reimbursements to physicians that take Medicare patients to prevent steep cuts scheduled for June 1. That would take care of the problem for up to five years." But some, including fiscally conservative Blue Dog Democrats, say the exemption for the so-called "pay fix" is too large. "A permanent extension of higher Medicare payments passed the House with fairly broad support last year on a 243-183 vote. Such a move would be impossible under the new pay/go law, but House Energy and Commerce Chairman Henry Waxman said the fix should be generous, given last year's vote and the drama that played out with healthcare reform." Without a fix, Medicare doctors are in line for a 21 percent pay cut beginning June 1 (Cohn, 5/13).

In other Capitol Hill news, senators on the Senate Finance Committee have opened an investigation of Amedisys Inc. and three other companies as allegations rise that they "deliberately boosted the number of home therapy visits to trigger higher Medicare reimbursements," The Wall Street Journal reports. The companies' Medicare patients used more higher-cost therapy visits than others and fewer of the cheaper therapy visits. "Companies 'working with Medicare should not be allowed to target seniors or manipulate care simply to get higher reimbursement rates,' said Sen. Max Baucus (D., Mont.), chairman of the finance committee, in a statement. ... [Among the companies,] Almost Family didn't provide comment. Representatives for LHC, Gentiva and Amedisys said they would cooperate with the probe" (Martinez, 5/13).