Congress Stops Medicare Pay Cuts; Now It's Your Turn

December 9, 2010

Everyone take a deep breath. You won't have to put your foot in the door to stop Medicare patients from coming to see you or consider the move to concierge medicine just yet, as Congress has officially delayed pay cuts for physicians.

Everyone take a deep breath. You won't have to put your foot in the door to stop Medicare patients from coming to see you or consider the move to concierge medicine just yet, as Congress has officially delayed pay cuts for physicians.

The U.S. House today joined the Senate in passing the "Medicare and Medicaid Extenders Act of 2010," a bipartisan bill extending current Medicare payment rates through Dec. 31, 2011. This means no cuts of upwards of 30 percent to doctors nationwide as was expected with the coming new year. The $15 billion price tag for the delay will come from the federal government recouping excess subsidy payments for those who qualify for Medicare, but their economic situation later changes.

By a vote of 409-2, [Reps. Brian Baird (R-Wash.) - a clinical psychologist -and Tom McClintock (R-Calif.) were the "nay votes"], the House approval now sends the measure to President Barack Obama's desk.

The president is sure to sign the legislation, voicing his pleasure in the Senate's previous action earlier this week to prevent pay cuts to the nation's doctors and preserve care for its seniors.

"For too long, we have confronted this reoccurring problem with temporary fixes and stop-gap measures," the president said in a statement. "It’s time for a permanent solution that seniors and their doctors can depend on and I look forward to working with Congress to address this matter once and for all in the coming year.”

If you're keeping track at your practice - and from your comments online you are - this will mark the sixth time in the past 346 days that U.S. lawmakers have pushed scheduled cuts under Medicare's sustainable growth rate (SGR) formula farther down the line. These short-term fixes got us to the point we are at today, but now the game has changed completely.

Essentially, the clock on cuts taking effect has slowed down, but the one keeping tabs on a true, long-term fix to the SGR just started ticking. Dec. 31, 2011 seems a long time away, but it really isn't for the monumental task that now faces legislators and healthcare stakeholders.

President Obama reminds us all of this in his statement.

Now it is up to you. Yes you, the small, solo doctor who feared that you would have to turn away your favorite senior citizen patients. The one who has been crunching numbers for the past three months trying to figure out how you were going to go on - or even which staff members to lay off - amid a 30 percent reduction in your reimbursements.

You made your voice heard to get Congress to delay these cuts for a year. Now you need to remain vocal to get them from coming back.

The American Medical Association is also on the hook now. Let's not forget it was the national doctor's group that initially pushed for a 13-month break from the Medicare payment cuts to help legislators figure out what president Cecil B. Wilson called a "Draconian" system to reimburse physicians.

Dr. Wilson, your wish has been granted.

In a statement, Wilson said the AMA, "will be working closely with congressional leadership in the new year to develop a long-term solution to this perennial Medicare problem for seniors and their physicians. This one-year delay comes right as the oldest baby boomers reach age 65, adding urgency to the need for a long-term solution before this demographic tsunami swamps the Medicare program.”

If the AMA wanted "urgency," it got it. It will be interesting to see how the group moves forward to get a true fix once and for all. Day one of their 377-day countdown just began.

Back to you, now. What can you do to fix this problem? What are your ideas and solutions? Do you trust the AMA to be at the forefront? Would you rather see another group leading the charge for consistent pay for physicians?

Weigh in below. I'll be checking back your comments around Day 370 or so.