What's at Stake in the New Medicare Bill

Opponents say that the removal of competition would have ultimately led to higher prices.

Nevertheless, now that the bill has been ratified, the procurement process pilot will be placed on hold for 18 months -- plenty of time for the debate to continue.

Some of the cuts in reimbursements under Medicare Advantage affect the teaching hospitals that were receiving expenses, as well as the insurers where they provided clinic care. The double cost will be eliminated.

The high-cost private fee-for-service plans (PFFS) operated by the insurers are now required to establish a provider network unless exempted because of insufficient network plans.

Overall these changes in Medicare Advantage are expected to reduce the rapid growth of the plans and the enrollment in PFFS.

Physicians are being encouraged by the new law to make use of electronic prescriptions by receiving a small increase, and this will become a requirement or they will receive lower payments by 2011.

On an overall positive note for seniors, the new law prohibits the often-uncomfortable situation of having cold callers selling Medicare Advantage plans door-to-door and the selling of other non-health-related products. Often, these salespeople wrongly told seniors that they had to sign up or they would lose their coverage. Further, the disguising of sales events as health-education seminars has also been banned.

Advocates for mental-health reform are delighted that the law provides for coverage at the same deductible level as other medical care. Those who wanted improvements for low-income prescription-drug coverage are no less happy.