Nation's doctors push senators to reverse cuts in Medicare bill

WASHINGTON — Congress returns to work this week with Medicare high on the agenda and Senate Republicans under pressure after a barrage of radio and television ads blamed them for a 10.6 percent cut in payments to doctors who care for millions of older Americans.

The ads, by the American Medical Association, urge Senate Republicans to reverse themselves and help pass legislation to fend off the cut.

It is an issue that lawmakers are forced to confront every year because of what is widely agreed to be an outdated Medicare reimbursement formula.

The dispute has reached a new urgency this year, with some doctors reassessing their participation in the program.

Just before the Independence Day recess, the House passed a bill to prevent the Medicare pay cut by a vote of 355-59. In the Senate, Republicans blocked efforts to take up the bill.

So the cut took effect July 1, although the Bush administration held off processing new claims to give Congress time to come up with a compromise.

The ads assert that Republicans have been protecting "powerful insurance companies at the expense of Medicare patients' access to doctors." The commercials were aimed at 10 Republican senators, including seven on the ballot this fall.

The Senate majority leader, Harry Reid, D-Nev., said he planned another vote this week, and the Democrats pressed their case over the weekend in their national radio address.

Democrats need just one more vote to pass the bill. But President Bush has vowed to veto it, so the fight — and the uncertainty — could continue for weeks.

Bush and many Republicans object to the bill because it would finance an increase in doctors' fees by reducing payments to insurance companies that offer private Medicare Advantage plans as an alternative to the traditional government-run Medicare program.

Military families have joined doctors and AARP in lobbying for the bill.

Relatives of active-duty military personnel, military retirees and their dependents receive care under the federal Tricare program, which uses the Medicare fee schedule to pay doctors.

More than 10 million of the 44 million Medicare beneficiaries are in private Medicare Advantage plans offered by companies like Humana, UnitedHealth and Coventry Health Care.

Many of these plans offer extra benefits such as vision and dental care.

But independent studies have repeatedly found that the private plans cost the government more per person than traditional Medicare.

Medicare receives 15 million claims a week for services paid under the physician fee schedule, so any change in payment rates has big implications.