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Life Health > Health Insurance > Medicare Planning

Leaders confident about Medicare doc patch

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(Bloomberg) — The U.S. Congress is racing to beat a March 31 deadline to avoid a 24 percent cut in Medicare physician pay rate.

The House today passed a one-year suspension of the payment rate cuts by a voice vote. The bill now goes to the Senate.

The House measure would replace the estimated 24 percent cut with a 0.5 percent increase in payments through Dec. 31, with no increase from Jan. 1 through March 31, 2015. The Senate hasn’t committed to holding a vote on the measure, though lawmakers say there’s still time to avoid the rate cuts.

Assuming Congress approves the new, temporary doc fix measure, this will be the 17th time lawmakers have prevented the Medicare “sustainable growth rate” (SGR) physician reimbursement system from taking effect in a decade.

A permanent doc fix proposal won support from both Democrats and Republicans, but the permanent doc fix bill that included the proposal stalled.

Republicans added a provision postponing the effective data of the Patient Protection and Affordable Care Act (PPACA) individual health coverage mandate to the permanent doc fix bill.

Lawmakers created the SGR system in 1997 budget bill. Drafters tried to hold Medicare costs down by tying increases in the reimbursement rate to growth in U.S. gross domestic product.

In practice, reimbursement rates have grown faster than GDP, but physicians have lobbied successfully to keep the SGR caps from affecting their pay.

The current SGR postponement authority “March 31 – Monday.

“What we do is not real,” Rep. Steny Hoyer, D-Md., said, adding that “everybody knows” lawmakers will delay the cuts again. “We want the medical community providers to continue to provide services to Medicare patients, to seniors. So we know we’re going to do it.”

Senate Majority Leader Harry Reid told reporters he wants to address the issue soon, though some lawmakers in that chamber have resisted the idea of approving a year-long bill instead of a permanent fix.

The Congressional Budget Office, Congress’s nonpartisan budget referee, says a permanent doc fix would cost a total of about $180 billion.

Rep. Joe Pitts, R-Pa., chairman of the House Energy and Commerce Committee’s health subcommittee, said lawmakers have been unable to come up with close to enough spending cuts or revenue additions to pay for a permanent doc fix.

The American Medical Association is opposing the temporary doc fix bill.

The legislation “actually undermines future passage of the permanent repeal framework,” AMA President Ardis Dee Hoven said in a statement.

Reid Blackwelder, president of American Academy of Family Physicians, said the temporary fix is a “missed opportunity to permanently repeal a flawed Medicare formula that has plagued the health-care system for more than 10 years.”

Hoyer said that, even after the March 31 SGR postponement authorization expiration date,Congress probably still has “flex time” to get a temporary fix passed.

That “flex time” could come from the Obama administration delaying cuts by weeks if Congress is close to a deal, or from lawmakers making the measure they pass retroactive. Congress has passed doc fix bills with retroactive fix provisions in the past.

–With assistance from James Rowley and Kathleen Hunter in Washington.

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