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    Throughout the hearing, the "big dog" in the room – as one witness referred to it – was the Sustainable Growth Rate (SGR). Each of the witnesses urged the Subcommittee Members to replace the current Medicare physician payment formula with a new model, saying that there's simply too much uncertainty surrounding the SGR. Though most seemed to agree, the price tag of repealing the SGR is daunting and the process of re-writing a billing system with 8,000 different codes will certainly take time. .Tragically, there are people who shamelessly try to take advantage of emergencies like the coronavirus pandemic to cheat other people out of money. Thankfully, federal agencies are mounting a multi-front attack on scams and quack cures in the wake of the crisis, an unprecedented coordinated effort that could continue for years to come. .One of TSCL's goals this year was to end "surprise billing" – the situation that happens when some types of medical providers, including anesthesiologists, radiologists, pathologists, and labs may not be contracted with your health insurer even though they provide services at a hospital or facility that is in your health plan's provider network. So, in addition to your expected out-of-pocket costs, you also get a bill for the difference between what your insurer has agreed to pay that provider and the amount the provider billed for their services. … Continued

  • Q August 2018

    Alexandria, VEighty-nine percent of people responding to a new poll by The Senior Citizens League (TSCL) are opposed to President Obama's executive action on immigration. The poll was conducted prior to the president's announcement of executive action that would allow an estimated 4.9 million unauthorized immigrants to avoid deportation. It asked, "Should President Obama bypass Congress to halt deportations of illegal immigrants?" Only 11 percent of those responding said "yes." .Democrats currently have an eight-seat majority in the House, meaning 10 defections could doom the legislation. Of those 10 members, seven got contributions last cycle from PhRMA, according to Federal Election Commission records. Six received donations from AbbVie's political action committee. .This week TSCL has been focused on two issues we are very concerned about. The first is the payroll tax cut that we told you about last week. As a reminder, President Trump has said he wants a payroll tax cut in the next financial relief legislation Congress develops in response to the coronavirus. TSCL opposes that because it would further damage the financial well-being of the Social Security and Medicare programs. Both programs already need fixing because the lack of financial resources in the coming years may result cutting benefits to seniors. In fact, Senate Majority Leader Mitch McConnell (R-Ky.) is among Congressional leaders who have already called for that, although they don't call it cutting benefits, they say there is a need to "reign in the costs" of the programs. … Continued

This week, one new cosponsor – Rep. Steve Israel (NY-3) – signed on to the Consumer Price Index for Elderly Consumers (CPI-E) Act (H.R. 1030), bringing the cosponsor total up to twenty-four. If signed into law, H.R. 1030 would adopt the CPI-E for the purpose of calculating Social Security cost-of-living adjustments (COLAs). Currently, COLAs are based upon the way young, urban workers spend their money – a method that underestimates the spending inflation seniors experience. H.R. 1030 would address this issue, resulting in more fair and accurate COLAs for seniors. .Congressional Republicans have also indicated opposition to the administration's proposal, saying it breaks from GOP philosophy by linking U.S. prices to those in other countries where there are price controls. While they like it in part, some Democrats have said it does not go far enough in lowering prices. The change would only lower prices for physician-administered drugs for people on Medicare, meaning people with private insurance and people getting drugs at the pharmacy counter would not benefit from lower prices. .At the hearing, Burwell made two key points of interest to TSCL. First, she commented that she fully supports President Obama's proposal to increase means testing within Medicare. TSCL opposes the President's plan since we fear that it could have unintended consequences that would ultimately drive up costs for many of the oldest and poorest seniors. Second, Burwell committed to work with Congress to repeal and replace the flawed sustainable growth rate (SGR) formula, which has brought instability to the Medicare program for more than a decade. TSCL supports efforts to find a permanent solution, since repealing the SGR will result in higher quality medical care for seniors. .In addition, the AHCA would repeal a tax created by the ACA that serves as a critical funding stream for Medicare's Hospital Insurance Trust Fund. Cutting the tax would accelerate the insolvency of the Medicare Part A Trust Fund, and in a matter of a few years, it would become exhausted. In a Washington Post opinion piece, former Acting Administrator of the Centers for Medicare and Medicaid Services (CMS) Andy Slavitt wrote, "That's clearly no accident: The program would wind up right where ‘entitlement hawks' such as House Speaker Paul D Ryan (R-Wis.) want it – in crisis. If this bill became law, the speaker would finally be positioned to change Medicare to a voucher program." .The CBO also notes that increasing the payroll tax rate or subjecting more earnings to the payroll tax could improve Social Security's financing. .Out-of-pocket spending on prescription drugs was the fastest rising expense of retirees from 2000 to 2019, according to a recent study of retiree costs by TSCL. While the annual cost-of-living adjustment (COLA) increased Social Security benefits by 50 percent over the period, out-of-pocket spending on prescription drugs rose more than five times faster — 253%. .TSCL enthusiastically supports the Strengthening Social Security Act and the Social Security Fairness Act, and we were pleased to see support grow for both of them this week. .Critics of mandatory arbitration say the agreements stack the deck against long term care residents and consumers. Unlike civil suits which go to court, arbitration is private, and there's no judge or jury. There are no rules of evidence that arbitrators have to follow under the law, and there's no oversight. Critics also contend that consumers are less likely to win their cases in private arbitration and, if they do win, they tend to get much less money than they would in court. .Sources: "Phone Scammers and ‘Tele-doctors' Charged With Preying On Seniors in Fraud Case," Victoria Knight, NPR Health News, October 7, 201"U.S. Thwarts Medicare Genetic Testing Scam," Associated Press, September 29, 2019.