{"database": "lobbying", "table": "lobbying_activities", "rows": [[466448, "25a47471-a0ed-4f2e-9686-0cab7b970142", "YY", "MARSHFIELD CLINIC HEALTH SYSTEM", 57830, "MARSHFIELD CLINIC HEALTH SYSTEM", 2006, "year_end", "MMM", "Subtitle D: Additional Demonstrations, Studies, and Other Provisions - \n(Sec. 646) Amends SSA title XVIII to direct the Secretary to establish a 5-year demonstration program under which the Secretary is required to approve demonstration projects that examine health delivery factors that encourage the delivery of improved quality in patient care. \n (Sec. 649) Directs the Secretary to establish a pay-for-performance demonstration program with physicians to meet the needs of eligible beneficiaries through the adoption and use of health information technology and evidence-based outcomes measures \nTitle IX: Subtitle E: Miscellaneous Provisions - \n(Sec. 953) Requires the Comptroller General to report to Congress on: (1) the appropriateness of the updates in the conversion factor including the appropriateness of the sustainable growth rate formula for 2002 and subsequently. \nDeficit Reduction Act (Section 5102) reduced reimbursements for multiple images on contiguous body parts in 2006; the DRA provision created in statute a basis for payment reductions on the imaging of contiguous body parts that CMS implemented through the rulemaking process in 2005; the DRA also requires that payment rates for imaging services delivered in physician offices do not exceed payment rates for identical imaging services delivered in hospital outpatient departments beginning in 2007.  Clinic recommends that Congress repeal Section 5102, and direct MedPAC and CMS to conduct a comprehensive study of imaging and the geographic variation in services. \nMedicare Advisory Committee review of the scientific evidence pertaining to vertebroplasty and kyphoplasty. \nCMS Physician Group Practice Demonstration     On September 27, 2002 the Centers for Medicare and Medicaid Services published a notice in the Federal Register informing interested parties of an opportunity to submit proposals for participation in the Medicare Physician Group Practice Demonstration (PGP) project.  Marshfield Clinic submitted a proposal for this demonstration and was selected by CMS to participate in the demonstration program, effective April 1, 2005.\nOppose limits on the laboratory CPI update.\nAmbulatory Surgical Center Medicare Payment Modernization Act of 2005, H.R. 4042/S. 1884 Legislation introduced by Representative Wally Herger (R-CA) and Senator Mike Crapo (R-ID), would amend the law to reform the method for determining Medicare payment rates for ambulatory surgical centers (ASCs). This legislation would expand Medicare beneficiaries\u2019 access to care in ASCs.\n\r\nTitle III: Combating Waste, Fraud, and Abuse - (Sec. 303) requires the Secretary, beginning in 2004, to make adjustments in practice expense relative value units for certain drug administration services when establishing the physician fee schedule.\nTitle IV: Rural Provisions - Subtitle B: Provisions Relating to Part B Only - \n(Sec. 412) Directs the Secretary to increase the work geographic index to 1.00 for any locality for which such work geographic index is less than 1.00 for services furnished on or after January 1, 2004, and before January 1, 2007. Since this provision expires at the end of 2006 it must be extended or revised.\n(Sec. 413) Establishes a new five percent incentive payment program designed to reward both primary care and specialist care physicians for furnishing physicians' services on or after January 1, 2005, and before January 1, 2008 in physician scarcity areas.\nDirects the Secretary to pay the current law ten percent Health Professional Shortage Area (HPSA) incentive payment for services furnished in full county primary care geographic area HPSAs automatically rather than having the physician identify the health professional shortage area involved.\nDirects the Comptroller General to conduct a study for a report to Congress on the differences in payment amounts under the Medicare physician fee schedule for physicians' services in different geographic areas. \nTitle VI: Provisions Relating to Part B - Subtitle A: Provisions Relating to Physicians' Services  \n(Sec. 605) Requires the Secretary to review and consider alternative data sources than those currently used to establish the geographic index for the practice expense component under the Medicare physician fee schedule no later than January 1, 2005. \n(Sec. 606) Directs the MEDPAC to submit to Congress: (1) a report on the effect of refinements to the practice expense component of payments for physicians' services after the transition to a full resource-based payment system in 2002; and (2) a report on the extent to which increases in the volume of physicians' services under Medicare part B are a result of care that improves the health and well-being of Medicare beneficiaries. \nSubtitle C: Other Provisions - \n(Sec. 626) Provides that in FY 2004, starting April 1, 2004, the ambulatory surgery center (ASC) update will be the Consumer Price Index for all urban consumers (U.S. city average) as estimated as of March 31, 2003, minus 3.0 percentage points. Provides that in FY 2005, the last quarter of calendar year 2005, and each of calendar years 2006 through 2009, the ASC update will be zero percent. \n(Sec. 628) Provides that there will be no updates to the clinical diagnostic laboratory test fee schedule for 2004 through 2008. \n\r\nHR 4157, the Health Information Technology Promotion Act, introduced by Rep. Nancy Johnson (R-CT) Rep. Nathan Deal establishes within the Department of Health and Human Services an Office of the National Coordinator for Health Information Technology.  \n\nPayment Fairness for Practice Costs\n\nThe formulas by which Medicare\u2019s payments are calculated are widely variable throughout Medicare localities, and are based upon outdated data assumptions regarding the cost and organization of medical practice.  Alternatives: CMS administratively revise its measurements of the costs of practice to assure the validity and fairness of payments; a payment floor could be established for practice expense; or the present variation (.705 \u2013 1.501) in practice expense could be channeled into a narrower corridor of adjustment \n\nPayment Equity\n\nIn MMA \u201803, Congress established a floor payment mechanism for the physician work component of Medicare payment for \u201804 \u2013 \u201806 to assure that physicians in low payment localities were compensated for their work at least at the national average payment amount.  This payment floor should be extended indefinitely or geographic adjustment of work should be eliminated entirely.\n\nH.R.5118 Section 5, SEC. 5. Extension of Floor on Medicare Work Geographic Adjustment. Introduced by Rep. Greg Walden\n\nMedicare Part D Call Center Requirements\n\nCMS issued a February 2006 guidance (Attachment 1) requiring customer service call centers to be open 8 a.m. through 8 p.m. 7 days per week, including holidays. Pharmacy technical help desks are required to be open 24 hours/day 7 days per week if there are network pharmacies open for this period. \n\nMedicare Prescription Drug, Improvement, and Modernization Act of 2003 - Public Law No: 108-173:\nTitle II: Medicare Advantage - Subtitle B: Immediate Improvements - (Sec. 211) Revises the payment system, requiring all plans to be paid at a rate at least as high as the rate for traditional Medicare fee-for-service plans. \nSubtitle D: Additional Reforms - \n(Sec. 237) Provides that Federally Qualified Health Centers (FQHCs) will receive a wrap-around payment for the reasonable costs of care provided to Medicare managed care patients served at such centers.\n (Sec. 238) Requires the Secretary to enter into an arrangement under which the Institute of Medicine of the National Academy of Sciences shall conduct an evaluation (for the Secretary and Congress) of leading health care performance measures in the public and private sectors and options to implement policies that align performance with payment under the Medicare program. \n\n\n\n\n\n\n\n\n\n\n\n\n\r\nthe provision of Medicare and Medicaid services and benefits to patients, incentives to promote electronic health records for all Americans, and prescription drug benefits.\n\nTax Relief and Health Care Act of 2006 (HR 6111) coupled a tax extenders and trade bill with a number of Medicare and Medicaid provisions including a physician fee freeze, a 1.5% bonus for physicians who report performance measures, extension of the Medicare physician work adjuster floor, and extension of the therapy services cap.\n\nSustainable Growth Rate\n\nMedicare\u2019s SGR mechanism unfairly links physician payment updates to factors unrelated to patients\u2019 needs and the cost of providing patient care. If the SGR formula is not changed, Medicare program trustees predict that Medicare physician payments will be cut by 31% between 2006-2013.  \nS.1081, by Senators Jon Kyl (R-AZ) and Debbie Stabenow (D-MI), the Preserving Patient Access to Physicians Act, would replace projected Medicare payment cuts with positive updates in each of the next two years.   \nH.R. 2356. Reps. Clay Shaw (R-FL) and Ben Cardin (D-MD) A bill to amend title XVIII of the Social Security Act to reform the Medicare physician payment update system through repeal of the sustainable growth rate (SGR) payment update system.   \n\nPay-for Reporting and Performance\n\nS 1356, Introduced by Senators Chuck Grassley (R-IA) and Max Baucus (D-MT), the Medicare Value Purchasing Act, a bill that links physician payment to quality performance, increasing payment by 2% incrementally between 2008 and 2012, and funding the performance payments by drawing funds from physicians who do not report quality performance.   \n\nHR 3617, the Medicare Value-Based Purchasing for Physician Services Act introduced by Rep. Nancy Johnson (R-CT) amends Part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to provide for value-based purchasing in the payment for physicians' services under the Medicare program. \n\nOn October 28, 2005, the Centers for Medicare and Medicaid Services (CMS) proposed the Physicians Voluntary Reporting Program (PVRP).  In the program CMS calls on physicians to report on a \u201cCore Starter Set\u201d of 16 evidence-based performance measures selected with input from the National Quality Forum, the Ambulatory Care Quality Alliance, and the National Committee for Quality Assurance, (NCQA).  \n\nInformation Technology\n\nS. 1418, the Wired for Health Care Quality Act introduced by Senator Michael Enzi (R-WY) - Amends the Public Health Service Act to establish the Office of the National Coordinator of Health Information Technology to coordinate and oversee programs and activities to develop a nationwide interoperable health information technology infrastructure.  \n\n\r\nProvisions of the President\u2019s FY2007 Budget and related appropriations legislation (H Con Res 376, S Con Res 83) and the Deficit Reduction Act (S 1932, HR 4241) related to implementation of the Medicare Advantage and Prescription Drug Programs,", "Agency for Healthcare Research & Quality (AHRQ),Centers For Medicare and Medicaid Services (CMS),Government Accountability Office (GAO),Health & Human Services, Dept of (HHS),Health Resources & Services Administration (HRSA),HOUSE OF REPRESENTATIVES,SENATE,White House Office", null, 154366, 0, 0, "2007-01-30T11:56:41-05:00"]], "columns": ["id", "filing_uuid", "filing_type", "registrant_name", "registrant_id", "client_name", "filing_year", "filing_period", "issue_code", "specific_issues", "government_entities", "income_amount", "expense_amount", "is_no_activity", "is_termination", "received_date"], "primary_keys": ["id"], "primary_key_values": ["466448"], "units": {}, "query_ms": 0.36031403578817844, "source": "Federal Register API & Regulations.gov API", "source_url": "https://www.federalregister.gov/developers/api/v1", "license": "Public Domain (U.S. Government data)", "license_url": "https://www.regulations.gov/faq"}