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The Senate on Tuesday overwhelmingly approved sweeping changes in the way Medicare pays doctors, clearing the bill for President Obama and resolving an issue that has bedeviled Congress and the Medicare program for more than a decade. (Pear, 4/14)

The unusually bipartisan bill, which passed the House easily last month, will immediately lift the threat of an automatic 21% cut in Medicare fees to physicians, which was set to take effect Wednesday. The legislation also marks a milestone in the push to modernize Medicare, the nation’s mammoth federal insurance program for the elderly, and move it away from the traditional system of paying physicians for every procedure they perform. The bill passed with an overwhelming majority, 92 to 8. (Levey, 4/14)

President Barack Obama has said he would sign the measure into law. Under the legislation, doctors would receive a 0.5% pay increase starting in July, with additional 0.5% annual pay raises through 2019, before the government starts giving new incentives to doctors to adopt alternative payment models instead of participating in the traditional fee-for-service program. (Hughes, 4/14)

The legislation repeals the old Medicare payment formula, called the Sustainable Growth Rate, and replaces it with a new one. It also funds the Children’s Health Insurance Program and community health centers for two more years. It will be paid for by having high-income seniors cover more of their Medicare costs and by requiring basic co-payments in Medigap plans. (Haberkorn, 4/14)

Sen. Rand Paul, R-Ky., one of three GOP senators who have announced that they are running for president, voted to approve the bill. The other two presidential hopefuls, Sens. Ted Cruz of Texas and Marco Rubio of Florida, voted against it. Senate Majority Leader Mitch McConnell said the bill would "ensure seniors on Medicare don't lose access to their doctors." Many doctors would have been reluctant to accept Medicare patients if the federal payments to physicians had dropped 21%, the bill's supporters said. (Kelly, 4/14)

Despite the last-minute nature of the vote, it was lauded by Hill leaders as a bipartisan triumph for both removing a yearly headache from the legislative calendar but also by implementing modest reforms to Medicare, including future incentives for doctors to deliver better care as well as premium hikes for the wealthiest Medicare recipients. ... The "doc fix" has been necessitated by a 1997 legislative provision known as the Sustainable Growth Rate, which mandated that Medicare fees could not exceed the growth in the overall U.S. economy. But as actual health-care costs have far outstripped the fee hikes allowed by the 1997 legislation, Congress has been forced to step in on a yearly basis to reset the rates or risk the possibility that many health-care providers would stop treating Medicare recipients. (DeBonis, 4/14)

Conservatives hated that it's expected to swell federal deficits over the coming decade. Liberals complained that it shortchanged health programs for children and women. But after years of complaints and failed efforts, huge majorities of both parties in Congress finally banded together and there was no stopping the "doc fix." (Fram, 4/15)

The measure, drafted last month by Republican House Speaker John Boehner and Democratic Minority Leader Nancy Pelosi, appeared to be the first major legislative accomplishment of the 2015-2016 Congress, suggesting some progress toward easing years of gridlock on Capitol Hill. (Cornwell, 4/14)

The nearly three-hour voting period began shortly after 7 p.m. on Tuesday, just before a key deadline that would have triggered double-digit cuts to Medicare doctors. The final votes were cast just before 10 p.m. Attempts to schedule a vote had been slowed to a halt by the half-dozen amendments floated by both parties. (Sullivan and Ferris, 4/14)

The bill's passage brought statements of praise from both President Obama and Republican congressional leaders. "It's a milestone for physicians, and for the seniors and people with disabilities who rely on Medicare for their health care needs," Obama said in a statement before later adding "I will be proud to sign it into law." Senate Majority Leader Mitch McConnell, R-Ky., said approval of the bill was "another reminder of a new Republican Congress that's back to work. And while no bill will ever be perfect, this legislation is a sensible compromise with wide bipartisan support; we look forward to the President following through on his commitment to sign it." House Speaker John Boehner, R-Ohio, who crafted the compromise bill with House Minority Leader Nancy Pelosi, D-Calif., called the reform's passage "a big deal." (4/15)

Medicare’s troubled physician payment formula will soon be history. As expected, the Senate Tuesday night easily passed legislation to scrap the formula, accepting a bipartisan plan muscled through the House last month by Speaker John Boehner and Democratic leader Nancy Pelosi. The Senate vote came just hours before doctors faced a 21 percent Medicare pay cut. (Carey, updated 4/14)

Top Democratic budget writers on Tuesday preemptively railed against the GOP’s yet-to-be-finalized spending blueprint even as they planned to force Republicans to cast more tough election year amendment votes on the budget. Senate Budget ranking member Bernie Sanders (I-Vt.) and his House counterpart, Chris Van Hollen (D-Md.), want to use the budget process to make Republicans vote on things like minimum wage, sick leave and privatizing Medicare. (Bade, 4/14)

Monday’s session demonstrated that VA’s entrenched culture of retaliation against whistleblowers endures, a year after revelations exploded over poor service and the covering up of long patient wait times. The retaliation continues despite the solid efforts of the current VA secretary, who replaced one driven out by the scandal. (Davidson, 4/14)

A Forida doctor accused of bribing U.S. Sen. Robert Menendez has been indicted on suspicion of carrying out extensive Medicare fraud at his eye-care practice for a decade and for treating patients for disorders they didn't have, officials said Tuesday. (Pearce, 4/14)

A Florida eye doctor facing corruption charges with New Jersey Sen. Robert Menendez was indicted Tuesday for health-care fraud, with prosecutors alleging he cheated the federal Medicare program while receiving payments of $105 million over six years. The payments to Salomon E. Melgen continued for much of that time despite scrutiny by federal officials, highlighting vulnerabilities in the federal program for the elderly and disabled. (Weaver and Stewart, 4/14)

Salomon Melgen, the Florida eye doctor whose gifts and campaign contributions led to the indictment of U.S. Senator Robert Menendez, was charged with 76 counts of health-care fraud and related offenses. Melgen submitted false claims, created fraudulent entries on patient medical charts and falsely diagnosed patients to bill for unnecessary tests and procedures, Miami U.S. Attorney Wifredo Ferrer said Tuesday in a statement. (Nesmith and Zajac, 4/14)

Florida doctor Salomon Melgen, who has been charged with corruption along with New Jersey Democratic Senator Bob Menendez, was indicted on Tuesday on Medicare fraud charges, the U.S. Attorney's office in Miami said. Melgen, 61, an ophthalmologist in North Palm Beach, was charged with 46 counts of healthcare fraud, as well as 19 counts of fraudulent claims, and 11 counts of making false statements relating to health care, prosecutors said in a statement. (Adams, 4/14)

But now, Melgen is facing more legal troubles. Federal prosecutors in Florida say Melgen, 61, would falsely diagnose patients at his southern Florida practice for eye conditions such as age-related macular degeneration, submit false Medicare claims and create fake entries on his patients’ medical charts. Melgen would then use the false diagnoses to perform “medically unreasonable and unnecessary tests and procedures” such as laser surgery and eye injections, prosecutors said. (Kim, 4/14)

The tax filing season has uncovered lingering wrinkles in the 2010 health-care law that have caused headaches for consumers who incorrectly estimated their income, didn’t use a government exchange to buy an insurance plan or changed coverage during the year. Marta Chapman saw her anticipated $850 federal refund wiped out because she received too much in advance tax credits in 2014 to pay her insurance premiums under the Affordable Care Act. That prompted her to drop her plan for this year. (Radnofsky, 4/14)

The special health insurance enrollment period set up for people surprised by their tax penalties hasn't appeared to increase either awareness or enrollment by much, new research shows. People who live in the 34 states that use HealthCare.gov and didn't know about the requirement to have health insurance can sign up through April 30 for 2015 coverage. (O'Donnell, 4/15)

How much is the so-called Cadillac tax anyway? The looming Obamacare tax on pricey health care benefits, at least at first glance, is 40 percent. But some experts say the true rate is much higher, more like 61 percent, because of some little-noticed quirks in how the tax works. (Faler, 4/14)

Federal health officials said publicly for the first time Tuesday that they want expansion of Florida's Medicaid program as part of any deal to grant Gov. Rick Scott's request to help the state's hospitals treat poor patients. Scott, so far, is refusing and with neither side backing down, that could lead to the Legislature failing to pass a budget before the scheduled end of its annual session May 1. Senate leaders say they will not approve a final budget that includes large cuts to hospitals. (Fineout and Kennedy, 4/14)

The federal government Tuesday explicitly linked two Medicaid-related programs, a move that could escalate a fight that already threatens creation of a state budget in time for the Legislature's adjournment on May 1. Talks between Gov. Rick Scott's administration and the federal Center for Medicare and Medicaid Services to extend the Low Income Pool program, which expires June 30, recently broke down amid finger pointing on both sides. LIP pays hospitals and others who provide care to low-income patients. The Senate has created a budget with both LIP and Medicaid expansion money, while the House's spending plan does not include those funds, creating a $4.2 billion gap that must be reconciled before lawmakers can go home. (Rohrer, 4/14)

Federal health officials turned up the pressure on Florida Tuesday, saying the future of $1.3 billion in federal funding for hospitals that treat low-income patients is tied to whether the Legislature expands Medicaid. In a letter to Florida’s Medicaid director, a top federal official wrote that the federal government is willing to consider the state’s request to keep the so-called Low Income Pool (LIP) in place after the program ends in June. But U.S. Centers for Medicare and Medicaid Services Acting Director Vikki Wachino noted "the state's expansion status is an important consideration in our approach regarding extending the LIP program." (McGrory, 4/14)

After losing the fight to block Medicaid expansion, a Koch-funded conservative group served up a gaffe that has state Democrats and political observers rubbing salt into the wound. ... The state chapter of Americans for Prosperity ... issued a statement Thursday ... saying it contradicted the wishes of “millions of Montanans” who “do not want more Obamacare.” ... “Yesterday, a ‘grassroots’ organization talked about the things #MillionsOfMontanans did. What else have #MillionsOfMontanans done? #MTLeg,” [Democratic Gov.] Steve Bullock tweeted. ... Around 1.6 million Twitter users saw the tweets — 600,000 more than state’s population. ... The contentious Medicaid debate helped the joke take hold, as did the way the gaffe poked at AFP’s out-of-state ties. (Brouwer, 4/14)

As Gov. Chris Christie tells audiences in New Hampshire that he wants to cut Social Security and other entitlement spending, his move to expand Medicaid in New Jersey has angered some Republicans. Since the decision two years ago to expand Medicaid in New Jersey under the Affordable Care Act, 400,000 more recipients have enrolled, state officials say. Overwhelmed by the surge, some counties paid staff members overtime to process applications. (Dawsey and Haddon, 4/14)

By most accounts, the state’s Medicaid expansion has been a success -- but not for the 9,000 to 12,000 residents still waiting for their applications to be processed. The botched rollout of a new Department of Human Services computer system and a fragmented, county-focused Medicaid application system have been blamed for the backlog. (Kitchenman, 4/14)

Clayton-based Centene Corp. could finally make headway on its long-term goal to spread its business across the state, thanks to the Missouri Senate. Senators narrowly approved a Department of Social Services budget last week that expands managed care of the Medicaid program. The expansion would shift 200,000 parents and children receiving traditional Medicaid to privatized managed care, exempting the elderly, blind and disabled. This could mean more money for Centene, whose subsidiary, Home State Health Plan, was one of three companies awarded the state’s managed care contracts. (Stuckey, 4/15)

Patient advocacy groups and Medicaid officials sharply disagree on whether HIV/AIDS patients are receiving adequate access to specialists and medications as states increasingly shift this population from traditional Medicaid to Medicaid managed care. (Dickson, 4/14)

A federal appeals court has rejected Wisconsin Sen. Ron Johnson's effort to stop members of Congress and their staffs from getting health insurance subsidies under President Barack Obama's 2010 healthcare law. The 7th U.S. Circuit Court of Appeals in Chicago said Johnson lacked legal standing to sue because he did not show he had been injured by the "special treatment" he claimed Obamacare gave senators, representatives and their staff. (4/14)

An appeals court Tuesday ruled that Republican Sen. Ron Johnson lacks legal standing to challenge the Obama administration's rule that members of Congress and their staffers seeking health coverage must get it through the District of Columbia small business exchange. A panel of the 7th U.S. Circuit Court of Appeals affirmed a lower court's ruling in deciding that the Wisconsin senator can't claim they've been hurt by the requirement. (Schencker, 4/14)

Electronic health records were supposed to make life better for patients and doctors -- getting rid of bulky and messy paper files, streamlining delivery of care and organizing medical information so that scientists can use it to make discoveries. But those benefits could be for naught if digital medical data aren't safe -- and they don't appear to be. A new analysis of government records, published Tuesday in the journal JAMA, found that close to a thousand large data breaches affected 29 million medical records between 2010 and 2013. (Brown, 4/14)

Large-scale health data breaches reported by doctors and health plans have been rising steadily, a new report shows. From 2010 to 2013, nearly 1000 large breaches affected more than 29 million individual health records, and more than half resulted from theft or loss of laptops, thumb drives and paper records, according to researchers with access to government data. (Doyle, 4/14)

Your private medical information is under threat. That's according to a study that found almost 30 million health records nationwide were involved in criminal theft, malicious hacking or other data breaches over four years. The incidents seem to be increasing. (4/14)

A Missouri lawsuit seeking class-action status accuses three insurance agencies of failing to safeguard sensitive consumer data from hackers who recently breached health insurer Anthem Inc.'s computer networks. A lawsuit first filed in February in St. Louis County on behalf of Jill Noble, a Richmond, Mo., woman was amended Tuesday to add three plaintiffs who allege personal data stolen during the breach in December or January is responsible for fraudulent tax returns filed in their name, costing them a combined $6,753 in refunds. (4/14)

Johnson & Johnson, the world’s biggest maker of health-care products, reported quarterly earnings that topped analysts’ estimates as new cancer and diabetes treatments helped push drug sales higher. The results underscore the company’s push to replenish its product lineup as drugs such as hepatitis C treatment Olysio and blood thinner Xarelto face new competition. (Koons, 4/14)

Following prodding from Congressional lawmakers, the Office of the Inspector General of the U.S. Department of Health & Human Services says it will conduct a new review of generic drug price increases on the Medicaid drug rebate program. The agency plans to review price increases between 2005 and 2014 in order to determine the extent to which generic drug prices exceeded the inflation rate, according to a letter the OIG sent to U.S. Sen. Bernie Sanders (I-Vt.) and U.S. Rep. Elijah Cummings (D-Md.). (Silverman, 4/14)

The nation’s largest tobacco companies are suing the Food and Drug Administration over recent guidelines that they claim overstep the agency’s authority over packaging for cigarettes and other tobacco products. Units of R.J. Reynolds Tobacco, Altria Group Inc. and Lorillard Tobacco filed the lawsuit Tuesday in the U.S. District Court for the District of Columbia, claiming the FDA’s guidance infringes on their commercial speech. (Perrone, 4/14)

The biggest U.S. tobacco companies on Tuesday filed a federal lawsuit against the Food and Drug Administration, challenging an alleged effort to assert authority over labels on tobacco products. Tobacco subsidiaries of Altria Group Inc., Reynolds American Inc. and Lorillard Inc. argue a recent FDA requirement violates free speech by requiring them to submit labels for approval. (Mickle, 4/14)

Henry Ford Health System, the Detroit-based system that has survived in recent years on a slim margin, largely broke even again last year. It did so with a small positive operating margin, compared with a small loss in 2013. Henry Ford's inpatient admissions dropped 2% in 2014 as the system worked to reduce avoidable readmissions and increasingly delivered care outside its hospitals, the system said in financial statements. Henry Ford reported 3% growth in demand for outpatient care last year. (Evans, 4/14)

The state has shelved its attempt to coordinate care of Medicaid beneficiaries who are elderly or disabled. The Georgia Department of Community Health said Tuesday that it was not proceeding “at this time’’ with soliciting bids from potential vendors to operate the program. (Miller, 4/14)

Hospitals and skilled nursing facilities in Kansas are part of an ongoing national conflict over “observation stays” that can leave the facilities and Medicare patients on the hook for uncovered rehabilitation costs after they leave the hospital. The conflict revolves around Medicare’s three-day rule, which requires a person to be admitted to the hospital on an inpatient basis for at least three days in order to qualify for inpatient rehabilitation at a skilled nursing facility, covered by Medicare, after they’re discharged. (Marso, 4/14)

A Greenville substance abuse center run by the state will no longer get Medicaid and Medicare funds for inpatient drug and alcohol treatment because of rules preventing such billing. The state says the center could not receive federal funds as a psychiatric hospital under U.S government standards if it served patients with substance abuse as their primary diagnosis. The change will result in a loss of $55,000 monthly at the 66-bed facility. DHHS says it's found savings at the center to make up for the loss. (4/14)

A health care union closely allied with Gov. Dannel P. Malloy announced Tuesday it has acceded to a request by the governor to postpone a nursing home strike by 3,500 workers at 27 facilities in 20 communities. (Pazniokas, 4/14)

Allen Dobson practices family medicine one day a week in Mount Pleasant, a two-horse town outside of Charlotte, North Carolina. He spends the other four days among Raleigh’s downtown high-rises, overseeing his brainchild, Community Care of North Carolina, the organization that manages the treatment for more than a million patients in North Carolina’s Medicaid “medical home” program. But recent threats to Dobson’s award-winning medical home model have him pulling more overnighters in Raleigh, and sending patients off to his partners. Although multiple auditors found that Community Care saved North Carolina about $1 billion over a four-year period, some lawmakers are pushing to replace Community Care in favor of a privately run managed care model. (Ferris, 4/14)

California has become a battleground between the tobacco industry and health groups as lawmakers push proposals that include increasing cigarette taxes by $2 a pack and raising the legal smoking age from 18 to 21. The state once led the nation in snuffing out smoking, but health activists say a strong tobacco lobby and a lack of political will have blocked new efforts in recent years. "We used to be leaders, and we are not anymore," said Stanton A. Glantz, a professor of medicine at UC San Francisco. (McGreevy, 4/14)

It’s just the crumb of a muffin but Martha Galvis must pick it up. Lips clenched, eyes narrowed, she goes after the morsel, pushing it back and forth, then in circles, across a slick table top. "I struggle and struggle until," Galvis pauses, concentrating all her attention on the thumb and middle finger of her left hand. She can’t get them to close. "I try as much as I can. And if I do it I’m so happy, so happy," she says, giggling. (Bebinger, 4/15)

After seventeen years (eight months, 9 days…), over a dozen acts of Congress and enumerable reams of debate and conjecture about its fate, it’s time to say goodbye to the Medicare Sustainable Growth Rate (SGR) formula. As a proper wake, let’s take a moment to reflect on this enigma of health care economic theory. And then let’s not ever do it again. (Billy Wynne, 4/14)

New Jersey Gov. Chris Christie would like to raise the age to qualify for Medicare, part of a bold plan to reform entitlements that he released Tuesday morning. The proposal was greeted with cheers from many conservatives, but there’s a twist. The main reason that slowly raising the retirement age from 65 to 69 is politically feasible is a law that many conservatives hate: Obamacare. (Haley Sweetland Edwards, 4/14)

If there's any immutable rule in politics, it should be: beware of candidates who try to be "bold" merely for the sake of looking bold. Chris Christie, trying desperately to keep his presidential hopes alive, wants to look bold, and he's not above throwing millions of elderly Americans under his campaign bus to do so. That's the only conceivable explanation for the New Jersey Republican governor's misinformed and dangerous proposals to "fix" Social Security. (Michael Hiltzik, 4/14)

[A new law] allows veterans to see non-VA health-care providers if they live more than 40 miles from the nearest VA medical facility, or if they cannot be seen at a VA facility within 30 days. The Veterans Choice Program isn’t a solution for every challenge the VA faces, and positive changes haven’t come as fast or been as thorough as some might like. But one large step forward came in late March when the VA announced that it was changing how the 40-mile rule is calculated. ... No exemption, however, has been announced for veterans who have a local VA that cannot serve their medical needs. For instance, a Vietnam veteran from Jackson, Tenn., currently seeks treatment for a neurological condition in Memphis, which requires him to travel, round-trip, 170 miles. He would prefer to visit a non-VA doctor closer to home through the Veterans Choice Program, but he is ineligible because he resides within 40 miles of a VA outpatient clinic—a clinic that does not have a neurologist on staff. (John W. Stroud, 4/14)

It may seem counter-intuitive to commit to expansion in a time of contracting state budgets. Nonetheless, when you dig deeper into the facts, figures and underlying rationale, it makes good sense to move forward with Medicaid expansion. Many come to the discussion with the core belief that all Alaska citizens deserve access to medical care, as a basic human need. I agree. I also believe Alaska should participate in Medicaid expansion because it makes good economic sense for our state. (Mike Navarre, 4/14)

In a number of states, parents are allowed to opt out of legal requirements to have their children vaccinated before entering school by claiming a “personal belief” or “philosophical” exemption. These provisions have raised a great deal of concern since the Disneyland measles outbreak, including in California, where it began. Unfortunately, the blundering approach state legislators there have taken shows how direct attacks on exemptions can rally the anti-vaccine cause. (Brendan Nyhan, 4/14)

What’s on kids’ school-lunch trays can have an impact that reaches far beyond the cafeteria — even to the frontlines where our men and women serve. If you’re wondering why a retired general cares about school lunches, know that childhood obesity is a serious national security issue. When I served as deputy assistant secretary of defense for military personnel policy, I was responsible for recruitment, retention and related human-resource management of the U.S. Armed Services’ 1.4 million active-duty members. That is why I am alarmed that nearly one in three young adults ages 17 to 24 is too heavy to serve in the military. (Samuel E. Ebbeson, 4/15)