Feb-08

AGS Continues Push for Proposed Geriatric Assessment and Chronic Care Act and Medicare Demonstration Based on the Act

AGS continues to advocate for passage of the Geriatric Assessment and Chronic Care Coordination (GACCC) Act and a Medicare demonstration project based on the Act. The Society worked closely with Congressional sponsors of the GACCC Act, which would fill a gap in traditional Medicare by covering geriatric assessment and care coordination for beneficiaries with at least two chronic conditions, including dementia.

Thanks to the ongoing efforts of AGS leaders, members, staff, and WolfBlock, AGS’ Washington representatives, the bill has bipartisan support in Congress. In addition, 34 organizations have signed on to support GACCCA. Members of AGS’ Care Coordination “SWAT” team worked with staff, WolfBlock, the Alzheimer’s Association, and sponsor Senator Blanche Lincoln (D-AR) to help draft legislation for the Medicare demonstration based on the GACCC Act. The project had been under consideration for inclusion in the end-of-the-year Medicare bill (see related story below).

When Congress was forced to pass a bare-bones Medicare bill to ensure timely enactment of a provision to temporarily block the scheduled 10% physician payment cut for 2008, the demonstration program, as well as other new proposals, was not included in the final measure. The demo program proposal could be resurrected, however, when the Senate Finance Committee hammers out new Medicare legislation later this year. In keeping with the demonstration, geriatricians and other qualified health professionals at up to 20 sites would provide geriatric assessments and chronic care coordination services to eligible beneficiaries with multiple chronic conditions.

2008 Physician Quality Reporting Initiative Launches

Medicare’s 2008 Physician Quality Reporting Initiative (PQRI) kicked off January 1. The initiative, which offers physicians and other eligible professionals bonus payments for voluntarily reporting quality data, will run through December 31. The 2008 PQRI includes 119 quality measures (detailed information about the measures is available on the Centers for Medicare & Medicaid Services (CMS) website at www.cms.gov/PQRI. Participating professionals can earn bonus payments of up to 1.5% of permitted charges for services payable under the Medicare Physician Fee Schedule. This year, as with last year, funds will come from the Medicare Part B Trust Fund.

AGS Signs On to Joint Principles of the Patient-Centered Medical Home Model

AGS recently signed on in support of Joint Principles of the Patient-Centered Medical Home (PCMH)—an initiative of the American College of Physicians, American Academy of Family Practitioners, and the American Academy of Pediatrics. AGS joined a number of other organizations supporting this initiative, including the American Medical Directors Association (AMDA) and the American Osteopathic Association (AOA). The Joint Principles (see https://www.paltc.org/publications/JointPrinciples.pdf​) address issues of quality and safety, access, and payment in the Medical Home model. Supporting the model, with its focus on providing comprehensive, coordinated primary care, is in keeping with AGS efforts on behalf of the Geriatric Assessment and Chronic Care Coordination Act, which aims to create a patient-centered approach under Medicare. (See story above.)

President Signs Omnibus Spending Package Funding Title VII Programs and Medicare Bill Delaying Physician Fee Cut

Title VII Geriatrics Health Professions Programs will get roughly $31 million in federal funds this fiscal year (FY)—about 1.7% less than the $31.5 million earmarked for the programs in FY 2007—under a $555 billion omnibus budget package that President Bush signed in late December. The President also signed a Medicare bill that, among other things, delayed a pending 10.1% physician fee cut that would have taken effect January 1. The $555 billion omnibus spending measure includes the FY 2008 Labor-Health and Human Services-Education appropriations bill and 10 other FY 2008 appropriations bills that had yet to be finalized.

The measure allocates a total of $194 million for all Title VII Health Professions Programs. Although this is 5% more than earmarked for the programs in FY 2007, funding for the majority of programs dropped roughly 1.7%. The new Medicare legislation will, among other things, delay for six months the scheduled 10.1% cut in Medicare physician pay rates and increase these payments 0.5% through June 30. Medicare's controversial Sustainable Growth Rate Formula mandated the cut. Congress will have to take up the physician pay issue again in mid-2008 if it’s to keep a cut from taking effect July 1. The Medicare measure also extends the State Children's Health Insurance Program (SCHIP) through March 2009 and makes several changes to the Medicaid program.