The Heart Rhythm Society met with Senate Finance Committee Chairman Max Baucus (D-MT) as part of a closed meeting with medical society lobbyists on Friday, April 11, to discuss possible Medicare legislation. The proposal would extend the current physician payment update for the remainder of 2008 and provide a 1.1% update for 2009. It would also provide increased payments to primary care physicians, which would impact reimbursement for other physicians, since no additional monies would be made available to account for a primary care payment differential. Other possible inclusions in the bill are additional funding for PQRI, e-prescribing requirements, a nationwide pilot of the Patient Centered Medical Home demonstration project and rural extenders.

The additional payments for primary care services and the expansion of the medical home project are part of recommendations MedPAC discussed during their April meeting and will be included in their May report to Congress. [Click here for more information on the MedPAC Meeting.]

E-prescribing language could provide a $1,000–$2,000 start-up bonus for electronically prescribing medications falling under Medicare Part B, and provide additional bonus payments thereafter.

The estimated cost for this package will be at least $8 billion. Under a current Congressional pay-go rule, new expenditures will have to be offset through cuts in other programs, but possible sources were not discussed. Because of cost concerns, a comparative effectiveness proposal — which would have funded research comparing differing treatments of the same condition — is likely to be off the table.

While a permanent rather than a temporary fix to the SGR physician payment formula is the preferred approach, and a payment differential for primary care physicians is a concern, Heart Rhythm Society lobbyists are currently working with other medical society lobbyists to determine how to best respond to this proposal.