“With today’s vote the Congress is delivering on a much-needed, well-deserved entitlement for America’s seniors,” said House Energy and Commerce Committee Chairman Billy Tauzin (R-LA).  

“Whether you’re one of millions of America’s seniors who currently relies on Medicare for day-to-day health care needs or a baby boomer inching towards enrollment, this critically-important new benefit will mean permanent prescription drug access, lower drug costs and a limit on catastrophic drug expenses. 

“Simply put, when this bill is enacted into law, seniors will spend less money on prescription drugs and spend less time filling out complicated forms. That’s good news for our mothers and fathers, grandmothers and grandfathers.” 

Today’s vote culminates months of policy discussions, dozens of hearings and countless hours of debate by the Energy and Commerce and Ways and Means Committees.  Both panels approved similar versions of The Medicare Modernization and Prescription Drug Act of 2002 last week. 

The Energy and Commerce Committee incorporated many provisions into the final bill passed by the House today, including: 

• Lowering monthly premiums to $33

• Limiting out of pocket expenses to $3,700 per year

• Providing free physicals to new Medicare beneficiaries

• Exempting those who rely on home health care from co-payments 

Specifically, The Medicare Modernization and Prescription Drug Act of 2002 does the following: 

• Provides an affordable and permanent prescription drug benefit for as little as $33 a month available to all seniors. This is a voluntary program that guarantees seniors’ the ability to choose among plans to find what works best for their Rx needs.  

• Includes a standard benefit that begins with a $250 deductible and pays 80% of spending up to the first $1,000 and 50% up to $2,000.  Medicare beneficiaries who meet the low-income criteria (44% of beneficiaries nationally) will pay less than $5 per prescription.  All participants are protected against catastrophic costs, with out-of-pocket expenditures capped at $3,700 per year.   

• Offers immediate savings to seniors through an interim discount card. 

• Earmarks $2 billion for Medicaid DSH (disproportionate share hospitals) payments to hospitals that provide care to the most under-served communities and the neediest seniors.   

• Provides substantial relief for physicians and hospitals who were incurring reductions.   

• Stabilizes Medicare+Choice by creating a new competitive structure for M+C plans to assure that seniors will have dependable choices, premium savings and early access to the various medical service and treatment innovations that are commonly available to the private sector first.  One measure provides for development of a new, competitive bidding system that could allow beneficiaries to realize savings of 25% off their premiums.  

• Increases incentives for providers to serve patients in rural areas and communities, which are essential to ensure that people everywhere have access not only to the prescription medicines they need, but also the best medical care possible.  

• Beefs up payments to sole community hospitals, those hospitals in the most isolated of areas. Provisions also will speed the integration of new technologies into hospital treatment regimens -- all measures to strengthen and increase the delivery of quality care and promote innovation. 

• Returns a level of certainty to physician payments to increase the quality of care available to seniors. The net effect -- as with measures to strengthen and increase ability to deliver quality care for patients at hospitals -- is that physicians will see a substantial increase in Medicare payment adjustment rates and seniors can be more assured that they’ll have doctors to see when they need to see them.  

• Establishes an independent agency to administer Rx benefit standards to avoid conflicting interests that might occur if an agency both sets the standards and administers its own plans; this would be the case if benefits were administered directly under the Medicare program. 

• Addresses concerns regarding regulatory cost and delay under Medicare (problems repeatedly expressed by beneficiaries, physicians and other providers) eases paperwork burdens and improves Medicare’s responsiveness to beneficiaries and health care providers.  This will allow more time for physicians to spend caring for their patients rather than filling out burdensome paperwork.