Bill To Rework Medicare Payments for Physicians Falls Short in Senate

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On Wednesday, the Senate voted 47-53 to reject cloture for legislation (S 1776) that would permanently change how physicians are paid under Medicare, falling 13 votes shy of the necessary 60 votes needed to proceed, CQ Today reports (Armstrong, CQ Today, 10/21).

The bill -- introduced last week by Sen. Debbie Stabenow (D-Mich.) -- was designed to avert a 21% Medicare payment reduction scheduled to go into effect on Jan. 1, 2010. The bill also would have repealed the current sustainable growth rate formula used to determine Medicare physician payments (California Healthline, 10/21).

Thirteen Democrats joined all 40 Republicans in voting against cloture. Many lawmakers who voted against cloture said that the bill's 10-year, $247 million cost was too much to add to the federal deficit (Murray, Washington Post, 10/22).

Reid Says AMA Promised 27 GOP Votes

On Wednesday, Senate Majority Leader Harry Reid (D-Nev.) said that the American Medical Association had promised that 27 Republicans would vote for the Medicare physician payment fix, The Hill reports.

According to Reid, the figure "was pretty reasonable to assume since one of the co-sponsors of this legislation was (Sen.) Jon Kyl (R-Ariz.), the assistant Republican leader."

Kyl was not a co-sponsor of the legislation that the Senate voted on Wednesday, but he has co-sponsored similar legislation in the past.

Reid said that he was "stunned" when Stabenow told him that Kyl "couldn't support the legislation" (The Hill, 10/21). Reid said, "Republicans are opposing this even though they support it" (Stanton, Roll Call, 10/21).

James Rohack, president of AMA, said, "The reference to 27 votes was made well before S 1776 was introduced and in the context of bipartisan health reform legislation," adding, "The majority of Democrats and Republicans support SGR repeal for seniors and baby boomers, but today's vote appears to be becoming the victim of Senate politics" (The Hill, 10/21).

Reid Commits To One-Year Pay Fix

Following the vote, Reid said that he is committed to implementing a one-year payment fix included in the Senate Finance Committee's health overhaul bill (S 1796) that would establish a 0.5% increase in Medicare physician payments in 2010 (Edney, CongressDaily, 10/21).

"We'll take this up again when we finish health care," Reid said, adding, "[W]e'll have a multiple-year fix for this. Right now, we'll only have a one-year fix" (Bolton, The Hill, 10/21).

Senate Budget Committee Chair Kent Conrad (D-N.D.) and Sen. Chuck Grassley (R-Iowa) already had begun working on an alternative to Stabenow's bill that would cost $25 billion over two years and be fully offset (California Healthline, 10/21).

The proposal would create a spending commission in charge of setting the Medicare physician formula.

Sen. Joseph Lieberman (I-Conn.) said that such a commission is needed to fix problems with the current formula, adding that the issue "really ought to be done as part of overall Medicare reform" (CongressDaily, 10/21).

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