Lawmakers Let Physicians Pay for Own Medicare Patch

November 19, 2010

Physicians nationwide can enjoy their Thanksgiving without having to worry about a 23 percent Medicare cut this year, but the solution from lawmakers may still leave them with some indigestion.

Physicians nationwide can enjoy their Thanksgiving without having to worry about a 23 percent Medicare cut this year, but the solution from lawmakers may still leave them with some indigestion.

Late on Thursday (Nov. 18), the U.S. Senate approved the “Physician Payment and Therapy Relief Act of 2010,” a bill proposed by Senate Finance Committee Chairman Max Baucus (D-Mont.) and Ranking Member Chuck Grassley (R-Iowa). The measure was approved by unanimous consent of the entire Senate and now goes to the U.S House for its approval before the bodies recess for Thanksgiving.

House Majority Leader Steny H. Hoyer (D-Md.) said he plans to schedule consideration of the Senate bill on November 29, to send to President Obama’s desk just before the cuts are to take place, adding his hope for bi-partisan support similar to that in the Senate.

The Senate solution provides a month-long extension to proposed cuts to physicians until Jan. 1, 2011, a delay estimated by many to cost about $1 billion. So how do Baucus and Grassley plan to scrape up the cash to put off the proposed cuts?

According to a joint statement by Baucus and Grassley, the short-term delay gets its funding by utilizing savings from a new CMS policy reducing payments for multiple therapy services provided to patients in one day. The pair point out, however, that the proposal also provides “relief” to therapists by reducing their cut from 25 percent to 20 percent, and at the end of the day saves us all $1 billion.

But as a Republican staffer speaking to The Hill notes, as did many physicians responding to the legislation via Twitter, those proposed cuts to therapists were to go to Medicare Physician Fee Schedule participants, but are now being used for the one-month delay.

So, as the staffer so eloquently put it, the Senate is telling physicians, “pay for your own fix.”

Let’s not end on a negative note, because Baucus and Grassley also have committed to pursuing a “year-long fix” to the Medicare sustainable growth rate (SGR) formula, before Jan. 1. The pair said in a statement they are “working together to secure a mutually agreeable way” to pay for the year-long delay, and “felt confident they would find such a solution.”

A quartet of representatives in the U.S. House have proposed legislation calling for a 13-month delay already, according to various reports.

Recently, AMA President Cecil B. Wilson said his group’s desire for a 13-month delay to address and correct the SGR formula would cost about $15 billion.

So one can only wonder how physicians might be called upon to pick up the tab for a $15 billion “doc fix” as they just graciously paid for a one-month delay.

In a statement, Wilson praised the Baucus-Grassley plan as providing “some stability” into the Medicare program for not only physicians, but also seniors and military members who rely on this for their health care. As he did in a recent interview with Physicians Practice, Wilson pushed for the 13-month delay into 2012 to stop enacting short-term patches and once and for all solve the SGR puzzle.

With the Senate action coming on the heels of the AMA’s “White Coat Wednesday,” where doctors called their legislators, Wilson said the congressional body “listened to the voice of the American people and took quick action.”

So if you are a physician and don’t want to pick up the $15 billion tab for Congress to figure out how to pay you more efficiently for your Medicare patients, might I suggest you keep those lines of communication open to Washington, D.C.