Medicare mover and shaker planning to leave Congress

Washington -- After 14 terms in Congress, Rep. Bill Thomas (R, Calif.) is leaving Capitol Hill at the end of this year, but the lawmaker indicated he's not quite done leaving his mark on Medicare.

As chair of the influential House Ways and Means Committee since 2001 and head of the panel's health subcommittee for six years before that, he emerged as the House Republican point man on Medicare issues. Thomas, who announced his retirement March 6, would have lost his committee post at the end of the year because of term limits.

He played a key role in reversing several rounds of Medicare reductions to physicians in recent years, most recently helping to approve a reimbursement freeze in place of the cut that temporarily went into effect in January. By citing "the problems caused by our outdated entitlement programs" in his farewell statement, he left the door open to making a last push to overhaul the payment system.

"I haven't finished my work, and I have nine months to go," he told reporters after making his announcement. "So rather than read my headstone now, let's see if I can't carve a few more things in it before you retire me."

Thomas has substantially influenced the nation's health care policy and will continue to do so in the coming months, said American Medical Association Board Chair Duane M. Cady, MD.

"The AMA has worked with Chairman Thomas on reforming Medicare physician payment, medical liability reform and other issues critical to the health of America's patients during his years of public service," Dr. Cady said. "We continue to work together to improve the quality of care for America's patients."

Congressional aides and lobbyists who work with Thomas predicted that he would make one last push this year to hammer out a long-term payment reform plan for doctors. Investigating the billing practices of nonprofit hospitals also might feature prominently on his final Capitol Hill health agenda, they said.

Thomas has sometimes butted heads with the physician community over how to replace the Medicare physician payment formula. In the months leading up to the 2006 payment cut and subsequent freeze, he publicly criticized the AMA and other doctor groups for advocating reimbursement increases while resisting a Medicare pay-for-performance plan they considered flawed. He also found himself at odds with physicians over his support of Medicare cuts included in balanced budget legislation in the late 1990s and managed care reform measures.

In announcing his retirement, Thomas cited the Medicare Prescription Drug, Improvement and Modernization Act of 2003 as one of three major accomplishments of his time at the Ways and Means helm. The law was largely written by Thomas and enacted after months of negotiations led by the lawmaker.

"We passed over $2 trillion in tax relief for hard-working American families, we provided the president with trade promotion authority so that he could seek freer and fairer trade markets, and we approved a long-overdue voluntary prescription drug benefit in Medicare for the first time in the program's history," he said. Thomas declined to say what he plans to do once he leaves his powerful House seat. Reps. Jim McCrery (R, La.) and Clay Shaw (R, Fla.) are likely possibilities to replace him as panel chair, aides said.