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Medicare Blog | Medicare News | Medicare Information

Medicare doctor payments in limbo this year

Posted by Guadalupe Cantu on Fri, Dec 06, 2013 @ 01:33 PM

Medicare Supplements Efforts to replace the Medicare physician payment formula for this year have all but been scrapped. Lawmakers have refocused their efforts and the new deadline for the doctors’ payment formula is 2014.

In a rare bipartisan, bicameral approach the Senate Finance and the House Ways and Means committees are to vote next week on a proposal that would repeal the Sustainable Growth Rate and formulate a new payment method for doctors and hospitals that treat Medicare patients.

The committee votes comes at the heels before Congress leaves town for the year and Capitol Hill is in a rush for a “quick patch” to prevent a 20.1 percent cut due in January to the current payment formula. I a short-term patch is not passed, Medicare could be put on hold until an quick fix is reached.

Earlier this year there was a major push to send the proposal to the president’s desk before year-end and eliminate the massive budget cuts that followed. Current goals have changed in both political parties and are working in an effort to pass the legislation in the committees this year and the Senate and the House in 2014.

In spite the effort to move the payment proposal forward, it is running into some resistance over policy and payment. Lawmakers and aids are in turmoil on how to approach Sustainable Growth Rate (SGR), said Rep. Jim McDermott, top Democrat on the Ways and Means Health Subcommittee and a physician. Pessimism on getting the formula repealed due to dispute over how to pay for it is also high.

“I don’t think they’re going to get a permanent fix,” he said. Republicans “won’t talk real revenues. They’re talking about taking it out of the hides of old people, and that’s not going to happen.”

Adding into the challenge of policy making, The House Republican Doctors Caucus is coming up with their plan, similar to other proposals. The House leaders know that gaining broader support and approval for the SGR replacement plan could be harder if it is not accepted by the GOP Doctors, said Rep. Phil Roe (R-Tenn.), co-chairman of the caucus. “The other members are going to say if the doctors aren’t for it; I’m not for it,” he said.

For years, Members of the Senate Finance, Ways and Means and House Energy and Commerce committees have wanted to repeal the Medicare formula, but there was no real support for the change. That’s because there was no real alternative system in place and repeal was estimated to cost $300 billion or more.

This year the effort got revitalized when the Congressional Budget Office scored repeal at $139 billion and consensus began to form around a replacement plan.

A repeal bill was unanimously passed this summer by The Energy and Commerce Committee and in October, the top Republicans and Democrats on the Finance and Ways and Means committees released a joint proposal will go before Finance on Dec. 12 and is estimated around the $200 billion.

But all focus remains on the “quick patch” for the impending cut and long-term goal of repealing the formula once and for all.

A three-month patch is sought by several leaders on Finance and Ways and Means and physicians. This would force lawmaker to vote for a new SGR bill, keep the cost down and finalize permanent repeal instead of repeat the entire cycle again.

Others would like to prolong the patch as long as they can afford it giving them time to fix the most controversial element of the patch, the payment method, including House Republican leaders, Roe said.

Providers wouldn’t be given too much stability with a short-term patch. The worst that can happen is after Congress did a quick fix, they would fail to reform the payment method.

In either case, this is a very important time, this opportunity for permanent reform should not be left to pass or “let it slip away,” said Bob Doherty, American College of Physicians lobbyist.

Please give us your feedback!
Question: Should the Senate Finance and the House Ways and Means committees’ vote for “quick patch” to prevent a 20.1 percent cut due in January, or should go past 2013 and focus on getting the current payment formula reformed?

Source: Politico
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Tags: Congress, Senate Finance Committee, House Ways And Means Committee, Medicare, Health Care

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