Last summer the US House of Representatives took action on a Bill that had manly to do with the State Children's Health Insurance Plan aka SCHIP(a worthy program that does a lot of good I'm sure). The House Bill dealing with this was called the Children’s Health and Medicare Protection Act or the CHAMP act.
Insurance for kids is a "have-to-fix" item on the Congressional agenda - there would be legislation the question was how big a program would the legislation fund. Because this must pass legislation fell under CMS it became a vehicle for other legislation involving a wide range of CMS programs, for instance provisions having to do with dialysis. The CHAMP act included a set of provisions that would have made substantial changes to the way the federal government pays for dialysis. There was a lot of debate in the renal community over the relative merits of the legislation but it turned out it didn't matter.
In the end it was a stripped down Bill that was passed and signed by the President. S. 2499 does not include any changes to dialysis reimbursement. But (always a but) there is a second have-to-fix item - Physician reimbursement. Long story, ... the physicians were facing a 10% cut unless something was done. Something was done but - S. 2499 includes only a six month physician reimbursement fix.
This means in the spring there will be another piece of must pass Medicare legislation to legislate the have-to-fix issue of Physician reimbursement under Medicare. We can expect many of the elements of the House CHAMP Bill to resurface in this must pass Medicare Bill. I'd expect in May or June: bundling; extending the MSP; and fewer federal resources going to the provision of dialysis - if the CHAMP act is the model.
Forget that nice orderly process you learned about in grade school, changes today are not made by individual Bills going through the legislative process culminating with the president's signature. Program changes great and small become law as part of a larger piece of legislation, which is why it is necessary to keep an eye on the Physician Reimbursement fix. Legislation which should start in the Ways & Means health subcommittee.
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