The 110th Congress is in its summer recess, and the usual calm before the storm is hovering over Washington. Fall always brings a harvest of legislative activity as lawmakers strive to deliver on promises that haven't materialized yet.
This Congress has struggled with dramatic partisan blockers when it comes to passing healthcare legislation. The Bush Administration has a clear view of where it wants to go with healthcare, with the Democratic majority in Congress fully eager to pass legislation opposed to those views. The result has been a frustrating year of stalemates.
The clearest example of the struggle has been the Medicare physician payment issue. After months and months of wrangling, Congress was finally able to block a 10.6 percent payment cut and provide a 1.1 payment increase for next year by overriding a veto. Temporarily, there was a sigh of relief on the part of doctors, but overall, they continue to complain that the odds seem to still be stacked against them to continue to take Medicare patients at this low rate.
With or without federal legislation, federal agencies can still drive change in healthcare and have promised to do just that. Department of Health and Human Services Secretary Michael Leavitt holds out Medicare—the largest U.S. healthcare payer – as a kingpin to change for the entire healthcare system. In August, he announced he would like to see local efforts almost doubled nationwide to make healthcare quality and pricing transparent to the public.
In the coming year, providers face a host of regulations making Medicare reimbursement more difficult. The National Provider Identifier, begun May 23, has reportedly caused headaches for those dealing with provider reimbursement. In addition, experts warn of a strict Medicare coding crackdown, which not only will delay payments but could bring enforcement action and provider pay-backs in the hundreds of thousands of dollars.
With the presidential election coming in November, many hope for fresh changes on the healthcare front in Washington. Both candidates pledge to lower the cost of healthcare and increase access to coverage, but their pledges are not silver bullets. The next president will have to guide his provisions through the gauntlet of Congress, which takes time. Meanwhile, providers will continue to wonder how to protect their bottom line and negotiate a seeming torrent of regulations in the process.