Senator Richard J. Durbin

June 5, 2008

Mr. Buddy Hosick

14592.wilburn.rd

West Frankfort, IL 62896

Dear Mr. Buddy Hosick:

Thank you for contacting me with your concerns about proposed reductions in Medicare physician payments and their effect on TRICARE beneficiaries. I appreciate hearing from you.

I have been a strong advocate for addressing this issue. Congress recently passed an amendment to a tax and trade bill (H.R. 6111) which delays for one year the 5.1 percent physician payment cut that would have become effective January 1, 2007, under the Medicare Sustainable Growth Rate (SGR) formula, thereby keeping Medicare physician payments at the current level. The provision also gives physicians and other health care providers a 1.5 percent payment increase if they submit data on quality-of-care measures.

I recognize that this is a temporary solution that does not address the larger problem associated with using the Medicare SGR formula to calculate payments for physicians and other health care providers in the Medicare program. The Medicare physician fee schedule was intended to compensate providers fairly for the care they offer while controlling overall program spending on physician and other provider services. Consequently, annual updates to the schedule depend not only on changes in costs associated with delivering patient care but also on bringing actual program spending on physician services in line with target spending levels.

The Department of Defense (DOD) is statutorily required to use the Medicare SGR to set its reimbursement rates for civilian physicians who treat TRICARE patients. Using the Medicare SGR formula would have led to a reduction in physician reimbursement rates for every year since 2001, including a payment cut of at least five percent effective January 1, 2007. However, Congressional actions I have supported have prevented reimbursement cuts for calendar years 2003 through 2007.

I am troubled by proposals that would undermine the federal government's commitment to provide health care for our active duty and retired service members. They deserve our support and our respect, and they need the assurance that TRICARE will reimburse physicians at a level adequate to ensure that doctors will continue to accept them as patients. Our failure to adequately reimburse physicians for their work destabilizes the TRICARE program and puts patient access to health care at risk. I will keep your interests in mind as I continue to fight to protect funding for this program.

Thanks again for your message. Please feel free to keep in touch.

Sincerely,

Richard J. Durbin

United States Senator

RJD/ds

P.S. If you are ever visiting Washington, please feel free to join Senator Obama and me at our weekly constituent coffee. When the Senate is in session, we provide coffee and donuts every Thursday at 8:30 a.m. as we hear what is on the minds of Illinoisans and respond to your questions. We would welcome your participation. Please call my D.C. office for more details.

June 5, 2008

Mr. Buddy Hosick

14592.wilburn.rd

West Frankfort, IL 62896

Dear Mr. Buddy Hosick:

Thank you for contacting me with your concerns about proposed reductions in Medicare physician payments and their effect on TRICARE beneficiaries. I appreciate hearing from you.

I have been a strong advocate for addressing this issue. Congress recently passed an amendment to a tax and trade bill (H.R. 6111) which delays for one year the 5.1 percent physician payment cut that would have become effective January 1, 2007, under the Medicare Sustainable Growth Rate (SGR) formula, thereby keeping Medicare physician payments at the current level. The provision also gives physicians and other health care providers a 1.5 percent payment increase if they submit data on quality-of-care measures.

I recognize that this is a temporary solution that does not address the larger problem associated with using the Medicare SGR formula to calculate payments for physicians and other health care providers in the Medicare program. The Medicare physician fee schedule was intended to compensate providers fairly for the care they offer while controlling overall program spending on physician and other provider services. Consequently, annual updates to the schedule depend not only on changes in costs associated with delivering patient care but also on bringing actual program spending on physician services in line with target spending levels.

The Department of Defense (DOD) is statutorily required to use the Medicare SGR to set its reimbursement rates for civilian physicians who treat TRICARE patients. Using the Medicare SGR formula would have led to a reduction in physician reimbursement rates for every year since 2001, including a payment cut of at least five percent effective January 1, 2007. However, Congressional actions I have supported have prevented reimbursement cuts for calendar years 2003 through 2007.

I am troubled by proposals that would undermine the federal government's commitment to provide health care for our active duty and retired service members. They deserve our support and our respect, and they need the assurance that TRICARE will reimburse physicians at a level adequate to ensure that doctors will continue to accept them as patients. Our failure to adequately reimburse physicians for their work destabilizes the TRICARE program and puts patient access to health care at risk. I will keep your interests in mind as I continue to fight to protect funding for this program.

Thanks again for your message. Please feel free to keep in touch.

Sincerely,

Richard J. Durbin

United States Senator

RJD/ds

P.S. If you are ever visiting Washington, please feel free to join Senator Obama and me at our weekly constituent coffee. When the Senate is in session, we provide coffee and donuts every Thursday at 8:30 a.m. as we hear what is on the minds of Illinoisans and respond to your questions. We would welcome your participation. Please call my D.C. office for more details.

Correspondence_Reply@durbin.senate.gov
To: algotto06@yahoo.com
Sent: Wednesday, May 7, 2008 4:48:19 PM
Subject: Message From Senator Durbin

May 7, 2008

Mr. Buddy Hosick

14592.wilburn.rd

West Frankfort, IL 62896

Dear Mr. Buddy Hosick:

Thank you for contacting me about the medical use of marijuana. I appreciate

knowing your thoughts.

Under federal law, it is illegal to manufacture, sell, or possess marijuana. While the

states have similar prohibitions, some states exempted from their prohibitions the

use of the drug purely for medicinal purposes. I oppose the legalization of marijuana

for general use. At the same time, I believe that marijuana may have medical

applications when prescribed by a doctor in specific cases, such as glaucoma or the

alleviation of pain in some patients with chronic illnesses.

The United States Supreme Court has ruled that there is no medical necessity defense

to the federal law prohibiting cultivation and distribution of marijuana - not even in

states that have created a medical marijuana exception to their comparable ban under

state law.

Despite this ruling, I am troubled that the Drug Enforcement Administration (DEA) has

been aggressively targeting medicinal marijuana providers even when they comply

with their own state laws. Given the DEA's limited resources, why is it so focused on

the medical use of marijuana?

Among the people the DEA has targeted is Suzanne Pfeil, who suffers from post-polio

syndrome. Her physician recommended medicinal marijuana, in accordance with

California state law, to help alleviate extreme pain and muscle spasticity. On

September 5, 2002, she awoke to the sight of five federal agents pointing rifles at her

head. After the DEA agents handcuffed her and left her lying in bed, the agents

confiscated her medication, despite California law and numerous studies showing

that her pain could be mitigated by medicinal marijuana.

Seriously ill individuals like Ms. Pfeil, who have a doctor's recommendation to

cultivate and use marijuana as a form of treatment, would benefit from a carefully

crafted medical use exemption that includes adequate safeguards against abuse. In

2004, I joined Senators Leahy and Jeffords in introducing the Truth in Trials Act,

which would have made changes in the Controlled Substances Act and the Federal

Food, Drug, and Cosmetic Act to accommodate states that have approved exemptions

for the medicinal use of marijuana. Unfortunately, this measure did not become law

before the end of the legislative session.

Thanks again for sharing your thoughts. Please feel free to keep in touch.

Sincerely,

Richard J. Durbin

United States Senator

RJD/tf

December 27, 2007

Mr. Alfred Hosick
14592 Wilburn Road
West Frankfort, IL 62896

Dear Mr. Hosick:

Since you have contacted me in the past in support of increased federal funding for veterans, I wanted to provide you with this update about recent developments that will help improve the welfare of troops and veterans.

I am pleased that we were able to increase funding for veterans programs for Fiscal Year 2008 in order to provide our past and present service members with adequate medical services and facilities. The Consolidated Appropriations Act of Fiscal Year 2008 (H.R. 2764), which Congress recently passed, will fully fund veterans' health care and boost veterans spending by $3.7 billion above the President's request. This much-needed funding increase - the largest in the 77-year history of the Department of Veterans Affairs (VA) - will allow the agency to better meet the needs of the men and women returning from Iraq and Afghanistan, as well as those who have served in the past.

In addition to increased funding for health care services, this legislation provides $75 million above the President's request to improve the management and efficiency of the VA health care system.

In May 2007, I introduced legislation to require the VA and the Department of Defense to implement a comprehensive program to diagnose, treat, and rehabilitate soldiers and veterans who have suffered a service-related Traumatic Brain Injury. Major portions of this measure were included in the Dignified Treatment of Wounded Warriors Act, which Congress passed as part of the Defense Authorization bill (H.R. 1585). That bill also now awaits the President's signature.

Veterans and their families deserve more than words of gratitude. Providing accessible and affordable health care is an important way of showing our support and gratitude for their service. I will continue to fight to fully fund the programs that our veterans deserve and depend on.

Sincerely,

Richard J. Durbin

United States Senator

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