(Bloomberg) — The doctors who treat Medicare patients would avoid a cut in their government reimbursements under a proposal to be presented to U.S. House members next week, according to Republican and Democratic aides.
The bipartisan $200 billion framework to replace Medicare’s cost-containment formula for doctor reimbursement was negotiated by House leaders of both parties and members of the committees with jurisdiction over Medicare.
Some of the cost would be offset with $35 billion worth of Medicare savings from beneficiaries over 10 years. Another $35 billion over a decade would come from reducing or delaying higher payments to hospitals and other Medicare service providers over time, the aides said.
The rest would be offset with $130 billion worth of adjustments in the budget resolution that would include government health programs, said a Republican aide who spoke on condition of anonymity because the proposal hasn’t been presented to members.
There’s pressure on Congress to act by March 31 to prevent a more than 20 percent cut in payments to doctors for treating Medicare patients.
Congress has avoided such payment cuts 17 times by passing what has become known as “doc-fix” legislation, or a change to the “sustainable growth rate” (SGR) Medicare provider reimbursement formula.
The $35 billion worth of Medicare beneficiary savings would be achieved in two ways. Private insurance companies that offer Medicare supplement (Medigap) policies—policies that supplement Medicare’s basic coverage—would be required to start paying benefits only after recipients pay $250 in out-of-pocket expenses for doctor visits, aides said.