Bush Freezes Cuts in Medical Fees

June 30, 2008

The Bush administration said Monday it is freezing a scheduled 10 percent fee cut for doctors who treat Medicare patients, giving Congress time to act to prevent the cuts when lawmakers return from a July 4 recess.

Physicians have been running ads hinting that as a result of the cuts, patients may find doctors less willing to treat them. The administration’s delay in implementing the cuts, which had been scheduled to go into effect Tuesday, spares lawmakers from having to use the recess to explain to seniors why they didn’t do the job before leaving town.

Kevin Schweers, a spokesman for the Department of Health and Human Services, said Monday the Centers for Medicare and Medicaid Services will hold doctors’ Medicare claims for services delivered on or after July 1. Claims for services received on before June 30 will be processed as usual, he said.

Congress, not willing to face millions of angry seniors at the polls in November, will almost certainly act quickly when it returns to Washington the week of July 7 to prevent the cuts in payments for some 600,000 doctors who treat Medicare patients. The cuts were scheduled because of a formula that requires fee cuts when spending exceeds established goals.

HHS Secretary Mike Leavitt had promised Friday that his agency “will take all steps available to the department under the law to minimize the impact on providers and beneficiaries.” On Monday, the department used its administrative tools to delay implementing the scheduled 10.6 percent cuts.

“By holding claims for health care services that are delivered on or after July 1, CMS will not be making any payments on the 10.6 percent reduction until July 15 at the earliest,” Schweers said.

Almost every year, Congress finds a way to block such cuts. But last week the Senate fell just one vote short of the 60 needed to proceed to legislation that would have stopped the cut.

In a particularly vitriolic exchange, Democrats and Republicans blamed each other for what Dr. Nancy H. Nielsen, president of the American Medical Association, said has put the country “at the brink of a Medicare meltdown.”

“Seniors need continued access to the doctors they trust. It’s urgent that Congress make that happen,” the AMA said in ads taken out in Capitol Hill newspapers read by members of Congress and their aides.

Doctors have complained for years that Medicare payments have failed to cover rising costs.

This year majority Democrats homed in on cutting the Medicare Advantage program, which is an ideological issue for both parties. The Bush administration and Republicans like Medicare Advantage because it lets the elderly and disabled choose to get their health benefits through private insurers rather than through traditional Medicare. Democrats argued that government payments to the insurers are too generous.

The White House warned that President Bush would be urged to veto a bill that contained cuts to Medicare Advantage.

That didn’t stop the House last Tuesday from approving the legislation 355-59, well above the margin needed to override a veto. Every Democrat supported it, and Republicans, bucking their president, voted 129-59 for it.

Originally found @ AssociatedPress.com

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Copyright 2008 The Associated Press. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.


Should Menthol Be Illegal in Cigarettes?

June 17, 2008

Is menthol a flavor that should be banned from cigarettes? That’s a tricky question, according to the American Medical Association whose members on Tuesday found themselves opposing some government health heavyweights.

Menthol flavoring would not be banned under a bill before Congress that gives control of tobacco products to the Food and Drug Administration. The bill would ban flavor additives such as mint, clove and vanilla, which appeal to young people.

Menthol is preferred by more than 75 percent of black smokers, according to government estimates. Fewer than 25 percent of whites smoke it.

“If we’re banning things such as clove and peppermint, then we should ban menthol,” said Dr. Louis Sullivan, health secretary from 1989 to 1993 under President George H.W. Bush and one of seven former health secretaries who sent a letter to lawmakers voicing opposition to the menthol exemption. “If it doesn’t happen, this bill will be discriminatory against African-Americans.”

Normally, the nation’s largest organization of doctors probably would agree. But in this case, the AMA president and many delegates support the menthol exemption pushed by the cigarette industry. The AMA voted Tuesday to refer the decision on menthol to its board, effectively silencing the doctors who wanted the organization to speak out against the exemption.

The reason is that the menthol exemption helped congressional leaders reach a bipartisan compromise on legislation that would put cigarettes under government regulation. Supporters say it would give the FDA authority to reduce harmful ingredients in cigarettes, require new health warnings and bar misleading labels such as “light” and “mild.”

Dr. Ron Davis, a preventive medicine specialist who is wrapping up his one-year term as president, said removing the menthol exemption from the bill might derail the legislation.

And while other flavor additives are aimed at luring young smokers, menthol is different, he said. Banning it would merely drive mature black smokers to other brands, said Davis. “It would change the entire political dynamic.”

Menthol cigarettes such as Kool were marketed during the 1960s in advertising campaigns targeting urban blacks, according to the National African American Tobacco Prevention Network. That group withdrew its support from the tobacco control bill last month over the menthol exemption and found allies in the former health secretaries.

The exemption harms the black community, said Robert McCaffree of the American College of Chest Physicians, the group that introduced the AMA proposal. He noted that cigarette maker Philip Morris USA supports the bill and the exemption.

William S. Robinson, executive director of the African American Tobacco Prevention Network, said the group believes a superior tobacco control bill could be crafted without the support of Philip Morris, which makes several menthol brands.
“We understand from an industry perspective why menthol is off the table,” Robinson said. “We think part of it is because menthol represents almost 30 percent of the $70 billion U.S. cigarette market.”

Philip Morris spokesman Bill Phelps said the bill would give the FDA authority to remove ingredients that are determined harmful to health.

“Based on our scientific judgment, menthol does not increase the inherent hazards of smoking,” Phelps said.

Originally found @ AssociatedPress.com

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Copyright 2008 The Associated Press. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.