H.R. 6331 passed by a remarkable margin of 69-30. When Senators Cornyn (R-TX) and then Martinez (R-FL) spoke against the bill and tried to introduce different legislation, I was concerned. Earlier, Senator Hatch (R-UT) said "We have been here twice before, the bill did not pass then and it will not pass today".

Was I watching a Senate debate or the final table at the World Series of Poker?

At stake: Not a million dollars and a bracelet, but the lives of millions of beneficiaries in 80 MSAs and more immediately, the closure of thousands of businesses and the employment status of tens of thousands in Round One. If H.R. 6331 failed to pass, then providers in 400 counties in the next 70 MSAs of Round 2 would be preparing to bid in a few weeks. They would be participating not knowing if their bid would be randomly disqualified, and competing against unqualified bidders under the same broken system.

Senators Cornyn and Martinez offered new legislation which would include a 30 day extension for doctors to try and fix the Medicare Advantage Program. Later Minority Leader McConnell (R-KY) explained that the delay would affect doctors and Competitive Bidding. That is enormous recognition, thanks to an incredible grassroots effort.

Fortunately it passed and although the focal point was the doctor's 10.6 percent pay cut, it was the Republican Senators in the Competitive Bidding states who made the difference and pushed the bill into veto proof status.

Round one of the program affected patients and providers in Cincinnati, Charlotte, Cleveland, Dallas, Kansas City, Miami, Orlando, Pittsburgh, Riverside and San Juan. Puerto Rico does not have Senators and California has two Democrat Senators. The remaining 8 MSAs are represented by 7 states, as the Kansas City MSA is split inside Missouri and Kansas.

Of the possible 11 Republican Senators in those states, 7 voted for the bill including: Mel Martinez (R-FL), Pat Roberts (R-KS), Elizabeth Dole (R-NC), George Voinovich (R-OH), Arlen Specter (R-PA), John Cornyn (R-TX) and Kay Bailey Hutchison (R-TX).

In March, during the AAHomecare Washington Conference, I had the opportunity to meet some amazing people from the Round 2 states. Their commitment to stop the program pushed the bill from questionable into cloture.

Eighteen Republicans voted for the bill. If you remove the Republicans from rural states without a metropolis: Alaska and Maine, 6 of the remaining 7 Republican Senators were from states with the largest areas in Round 2.

Both GOP Senators from Georgia and Tennessee voted for the bill. The Republican Senator from Minnesota and the one from Virginia voted for the bill as well.

It was a total team effort and it would not have happened without the passage in the House by a margin of 355-59. That is thanks to the participation of all providers who did not assume anything and educated their Democratic party legislators about the problems with Competitive Bidding in healthcare.

 

AMEPA's Next Goal: Bush's Signature on H.R. 6331
I know that everyone wants to get back to restoring their businesses but until President Bush signs H.R. 6331 into law, we may not have any official clarification from Medicare.

It is unlikely that President Bush will refuse and try to push the bill back to the Senate, especially in this election year. However stranger things have happened. He could delay and although he would have to lobby four senators to change their minds to lower the vote below two-thirds, (65 of 99) this is not an impossible scenario.

An Associated Press article in today's South Florida Sun-Sentinel stated: "President Bush's advisors have said they will recommend that he veto the bill."

It may be wise to contact the White House and ask when the President plans to sign the bill. Patients and Healthcare providers are scared and confused and the industry needs immediate relief.

In a large media presentation, the President signed the Foreign Intelligence Surveillance Act (FISA) into law, less than an hour after it passed. He could have done the same for H.R. 6331.

The White House can be reached at 1-202-456-1414

After the Medicare Improvements for Patients and Providers Act of 2008 becomes law, AMEPA will discuss our future plans. Those plans will change our industries reputation in the national media and unite the entire healthcare industry to stop Competitive Bidding from affecting Clinical Labs, Nursing, Home Healthcare, Hospice and Pharmacies.