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In a vote that surprised many veteran observers, the House overwhelmingly passed Medicare relief legislation Tuesday by a veto-proof vote of 355-59. Political leaders had expected a vote closer to a 50-50 split, or closer to party lines.

The focus shifts again today to the Senate, where Finance Committee Chairman Max Baucus (D-MT) has had no success building a veto-proof voting bloc earlier this year on similar bills. Long-term care lobbyists, however, were expressing some optimism that a bipartisan compromise deal was close at hand Tuesday and could be voted on today.

The House bill includes an 18-month extension of the therapy cap exceptions process. The exceptions currently shield a large percentage of long-term care therapy patients from the $1,790 annual limits for a) occupational therapy and b) speech and physical therapy combined.
The legislation notably also would postpone a planned 10% physician payment cut with a freeze for the rest of 2008 and a 1.1% increase for 2009. President Bush has threatened to veto the bill because it calls for cuts to the Medicare Advantage program.