Congress again stops cut to Medicare docs
Physicians faced 24 percent reimbursement reduction
WASHINGTON – With just hours to spare, Congress stepped Monday to finalize legislation to prevent doctors who treat Medicare patients from being hit with a 24 percent cut in their payments from the government.
The Senate’s 64-35 vote sends a measure to delay the cuts for a year to President Barack Obama, who’s expected to quickly sign it. The House passed the measure last week.
The $21 billion measure would stave off a 24 percent cut in Medicare reimbursements to doctors for a year and extend dozens of other expiring health care provisions such as higher payment rates for rural hospitals. The legislation is paid for by cuts to health care providers, but fully half of the cuts won’t kick in for 10 years.
It’s the 17th temporary “patch” to a broken payment formula that dates to 1997 and comes after lawmakers failed to reach a deal on financing a permanent fix.
The measure passed the House on Thursday, but only after top leaders in both parties engineered a voice vote when it became clear they were having difficulty mustering the two-thirds vote required to advance it under expedited procedures. Several top Democrats opposed the bill, saying it would take momentum away from the drive to permanently solve the payment formula problem.
There’s widespread agreement on bipartisan legislation to redesign the payment formula that would give doctors 0.5 percent annual fee increases and implement reforms aimed at giving doctors incentives to provide less costly care. But there’s no agreement on how to pay the approximately $140 billion cost of scrapping the old formula.
The heavily lobbied measure blends $16 billion to address Medicare physicians’ payments with about $5 billion more for a variety of other expiring health care provisions, like higher Medicare payments to rural hospitals and for ambulance rides in rural areas. Manufacturers of certain drugs to treat kidney disease catch a break, as do dialysis providers and the state of California, which receives increases in Medicare physician fees in 14 counties such as San Diego and Sacramento that are designated as rural and whose doctors therefore receive lower payments than their urban counterparts.
The bill increases spending by $17 billion over the next three years, offsetting the cost with cuts to health care providers. The authors of the bill employed considerable gimmickry to amass the cuts, however, and fully half of them don’t appear for 10 years. For instance, the bill claims $5 billion in savings through a timing shift in Medicare cuts in 2024.