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Leaders working on Medicare payments.

Byline: Alan Fram and Andrew Taylor

WASHINGTON -- Bipartisan House leaders are working on a $213 billion plan to permanently change how doctors are paid for treating Medicare patients, a costly problem that's vexed Congress for years, a document circulating among lawmakers showed Tuesday.

Many of the tentative plan's details had already been disclosed by lobbyists, legislators and congressional aides. Some particulars were new, such as setting a 2020 starting point for higher out-of-pocket expenses for people buying new Medigap policies, which cover costs not insured by Medicare.

Lobbyists and aides have said negotiators discussed requiring Medigap beneficiaries to pay $250 out of pocket, which proponents say would discourage people from unneeded medical expenses.

Around $140 billion of the proposal's 10-year costs would be financed by adding to federal deficits, the paper says.

That has led to criticism by some conservatives reluctant to drive up federal red ink that has fallen significantly in recent years.

Of the roughly $70 billion remaining, around half would be paid for by boosting some beneficiaries' costs.

That would include the higher Medigap costs and raising premiums that people earning over $133,000 yearly pay for Medicare doctors and drugs.

AARP, the politically potent organization representing seniors, warned Tuesday that the emerging deal ''is not a fair deal for America's more than 50 million Medicare beneficiaries.'' The group has generally supported efforts to permanently rewrite the law for reimbursing doctors because physicians have threatened to treat fewer Medicare patients because of the constantly threatened cuts.

Because seniors vote in disproportionately large numbers, criticism by AARP could make it harder for some lawmakers to support the package.

The remaining $35 billion in savings would come from Medicare providers and hospitals, though the document provides no details about that.

Aides to House Speaker John Boehner, R-Ohio, and Minority Leader Nancy Pelosi, D-Calif., have been working behind closed doors on the agreement.

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Author:Fram, Alan; Taylor, Andrew
Publication:Telegram & Gazette (Worcester, MA)
Date:Mar 18, 2015
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