Congress Overrides President’s Veto of Medicare Bill

July 15, 2008. The Medicare Improvements for Patients and Providers Act (H.R. 6331) will provide relief to low income beneficiaries while restoring provider payments.

On July 15, the House and Senate overrode the President’s veto of the Medicare Improvements for Patients and Providers Act of 2008, H.R. 6331 (MIPPA).  The new law retroactively rescinds a 10% reduction in Medicare payments to doctors that would have been effective July 1.  To pay for what is called the “doctor fix,” the bill provides for a modest reduction in payments to Medicare Advantage plans, managed care plans that are offered to Medicare beneficiaries as an alternative to original Medicare. 

The MIPPA also contains a number of important provisions advantageous to low income Medicare recipients.  They include: extension of the Qualified Individual (QI) program; phased-in parity for mental health in Medicare payments; exemption of in-kind support and life insurance cash value from counting for the Low Income Subsidy income and resource counting; and a permanent elimination of the Medicare Part D Late Enrollment Penalty for recipients of the Low-Income Subsidy (LIS).  Also, effective 2010, the asset levels permitted to qualify for the Medicare Savings Program will be raised to the same level as the asset level for the full LIS subsidy.

Many low income recipients will also benefit from provisions related to health care disparities.  The MIPPA requires the Secretary of Health and Human Services (HHS) to develop and implement a system for evaluating health disparities based on race, ethnicity and gender.  This effort will involve new attempts to collect race and ethnicity data on Medicare beneficiaries.  The law also requires the Inspector General of HHS to issue a report evaluating plan and provider compliance with language access requirements.  The report must be issued within the next two years and HHS must implement changes responsive to the recommendations in the report within one year.

The new law also provides additional funding for State Health Insurance Programs (which counsel and assist Medicare beneficiaries), prohibits a variety of abusive marketing practices employed by Medicare Advantage and Part D plans, and establishes standards for Private Fee-for-Service Plans and Special Needs Plans.

The MIPPA originally passed the House and Senate with veto-proof majorities.  The President vetoed the bill anyway on July 15th.  Congress acted quickly to override the veto the same day. The House vote on the override was 383-41.  The Senate vote was 70-26.  The full text of H.R. 6331 is available at http://thomas.loc.gov/