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Medicare

Tuesday, February 02, 2010

Pay-Go Approval Could Pave Way to Medicare Physician Payment Fix

Last week, the Senate took a first step toward addressing scheduled cuts to the Medicare doctor payment rate by exempting $82 billion in funding from pay-as-you-go rules that could be used to prevent five years of physician payment reductions, Politico reports (Frates, Politico, 2/1).

Legislation (H J Res 45) approved by the Senate would require Congress to pay for future spending without adding to the budget deficit, but the $82 billion would be exempt under the resolution.

However, Congress must authorize use of the funding in order to avoid a 21% Medicare physician payment cut that is scheduled to take effect March 1 (Reichard, CQ HealthBeat, 2/1).

A short-term measure offsetting the cut was passed last year, but it expires at the end of February (Young, The Hill, 2/1). If Congress approves the funding to offset the cuts, which are a result of the sustainable growth rate formula, it would be the longest payment fix lawmakers have approved since they began offsetting the annual scheduled cuts in 2002, according to Politico.

AMA, Other Groups Seek Long-Term Solution

Although the American Medical Association and other advocacy groups lauded the movement toward offsetting the scheduled cuts, the groups are continuing to push for a permanent fix (Politico, 2/1).

AARP and the Military Officers Association of America also support AMA's efforts to enact a permanent fix for Medicare physician payment rates (The Hill, 2/1).

On Sunday, AMA sent a memo to its membership calling for Congress to enact a permanent fix to Medicare payment rates (CQ HealthBeat, 2/1). AMA President James Rohack said, "Congress can no longer apply short-term fixes that increase the cost of a permanent solution and the size of the cuts" (Politico, 2/1).

Advocates noted that a permanent fix to the payment formula could be less costly than a temporary one.

An HHS document outlining President Obama's fiscal year 2011 budget proposal estimated that if Congress continues to temporarily block the payment reductions it would cost about $371 billion over 10 years.

However, legislation (HR 3962) passed in the House repealing the SGR would cost an estimated $209 billion over 10 years, according to Julius Hobson, an adviser for the lobbying firm Bryan Cave.

Obama administration officials have not taken a position on repealing the SGR (CQ HealthBeat, 2/1).



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