2010-05-20
The House Ways and
Means and Senate Finance Committee Chairmen have announced an agreement for a
four-year physician payment fix. The
expectation is that this will be voted on by the end of the week.
Medicare physician payment rates are scheduled to be cut by
21 percent beginning June 1 unless Congress passes legislation to prevent
the cuts. The new agreement (House amendment to HR 4213) would provide:
- 1.3 percent
update effective June 1, 2010
- An
additional 1 percent update on January 1, 2011
- From
2012-2013, annual updates are based on two target method contained in a House
passed bill (HR 3961) although updates for both service categories cannot be
negative in either of those years. During this period, physicians in
Accountable Care Organizations (ACO) may elect to establish ACO-specific spending
targets in lieu of national spending
targets.
- Following
2013, rates return to levels determined by the current sustainable growth rate system, but rates
will not be hardcoded.
The
Congressional Budget Office is still estimating the cost of this policy, but it
is expected that the price will not exceed the congressional budgetary allow
allowance.
A detailed summary of the bill is available, as are shorter summaries and localized data (where
available) on the components of the bill (job growth, closing loopholes,
individual & business tax relief, and assistance for individuals, etc).
Previously this year, Congress has twice allowed 30-day
extensions of the physician payment rate to expire, creating tumult for
patients and physicians because a 21 percent cut became the operative policy.
Recently, the House and Senate were struggling over how to prevent the
impending June 1 cut because of the expense of continuing to postpone the
scheduled cut and how to pay for it.
House and Senate
Democrats have wanted to create a five-year fix in the payment rate for
physicians, but Republicans and some moderate Democrats have been unwilling to
support this type of proposal because it would cost $88.5 billion and lacks the
offsets to pay for itself. Congressional budget rules (PL 111-139) would allow a five-year fix
without offsets, but the measure’s price tag has raised concerns among moderate
Democrats, who in the past have joined Republicans in calling for offsets. Two senators whose support once again seems central to getting a bill through - Ben Nelson (D-NE) and Olympia Snowe (R-ME) - both have said that they want to see the cost
of keeping the reimbursement rates as they are now, known around Washington as
“the doc fix,” offset by an equivalent amount of new revenue or reduction in
spending.
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