The troubled payment formula for Medicare physicians is one step closer to repeal.
The House Thursday overwhelmingly passed legislation to scrap Medicare’s troubled physician payment formula, just days before a March 31 deadline when doctors who treat Medicare patients will see a 21 percent payment cut. Senate action could come this week as well, but probably not until the chamber completes a lengthy series of votes on the GOP’s fiscal 2016 budget package.
According to a summary of the bill, unveiled by Republican and Democratic committee leaders earlier this week, the current system would be scrapped and replaced with payment increases for doctors for the next five years as Medicare transitions to a new system focused “on quality, value and accountability.”
Hundreds of state and national physician groups are urging Senate passage.
“It will relieve many years of frustration and uncertainty for all physicians by eliminating that sword of Damocles, that’s been hanging over our heads with regards to cuts and replacing it with a predictable albeit small increase in fees over the next four to five years,” said the Massachusetts Medical Society’s president-elect, Dr. Dennis Dimitri.
There’s enough in the wide-ranging deal for both sides to love or hate.
Senate Democrats have pressed to add to the proposal four years of funding for an unrelated program, the Children’s Health Insurance Program, or CHIP. The House package extends CHIP for two years. In a statement Saturday, Senate Finance Democrats said they were “united by the necessity of extending CHIP funding for another four years” but others have suggested they may support the package.
Some Democratic allies said the CHIP disagreement should not undermine the proposal. After the House approved the package by a vote of 392-37, Ron Pollack, executive director of the consumers group Families USA, urged the Senate to “adopt a CHIP funding bill as soon as possible. Families USA believes that a four-year extension is preferable to two years. We also know that time is of the essence, and it is crucial that the Senate act quickly.”
Some senators have also raised concerns about asking Medicare beneficiaries to pay for more of their medical care, the impact of the package on women’s health services and cuts to Medicare providers.
In a letter to House members before Thursday’s vote, the seniors group AARP said the legislation places “unfair burdens on beneficiaries. AARP and other consumer and aging organizations remain concerned that beneficiaries account for the largest portion of budget offsets (roughly $35 billion) through greater out-of-pocket expenses” on top of higher Part B premiums that beneficiaries will pay to prevent the scheduled cut in Medicare physician payments.
Hospitals, nursing homes and rehabilitation centers would see lower rates of increase, but are largely backing the legislation.
“Although nothing’s perfect, at a time when it’s so difficult to reach accord on really complicated issues, broad support for this solution is really impressive,” said Tim Gens, executive vice president at the Massachusetts Hospital Association. “And if it fails, we go back to these temporary patches that only solve the problem in a very expensive way for months at a time.”
Some GOP conservatives and Democrats are unhappy that the package isn’t fully paid for, with policy changes governing Medicare beneficiaries and providers paying for only about $70 billion of the approximately $200 billion package. The Congressional Budget Office Wednesday said the bill would add $141 billion to the federal deficit.
For doctors, the package offers an end to a familiar but frustrating rite. Lawmakers have invariably deferred the cuts prescribed by a 1997 reimbursement formula, which everyone agrees is broken beyond repair. But the deferrals have always been temporary because Congress has not agreed to offsetting cuts to pay for a permanent fix. In 2010, Congress delayed scheduled cuts five times. In a statement Sunday, the American Medical Association urged Congress “to seize the moment” to enact the changes.
Here are some answers to frequently asked questions about the proposal and the congressional ritual known as the doc fix. Continue reading