Legislators Set Sights On Temporary Medicare 'Doc Fix,' Again

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Politico: "Doctors and seniors lobbying to stave off looming annual Medicare cuts have won a reprieve of sorts but are still pushing for a permanent fix. The Senate on Thursday passed so-called pay-go legislation that would require Congress to pay for much of its future spending without adding to the deficit, but it exempted $82 billion from the requirement to prevent reductions to doctors' Medicare reimbursement rates." The move could prevent five years of cuts, the longest such stretch lawmakers would have approved since 2002. "The cuts stem from a 1997 balanced budget bill" (Frates, 2/2).

NPR's "Shots" health blog: "The automatic cuts are meant to control Medicare spending. But Congress, under pressure from doctors, has routinely overridden that mandate at the last minute to delay the scheduled pay cuts. But each year's postponed reduction gets piled onto the previous scheduled cuts, so the discount that is set to take effect March 1 now stands at 21 percent" (Villegas, 2/1).

Medscape Today reports that the possible temporary fix would freeze physicians' pay at 2009 levels until 2015, when rates would be on schedule for 25 to 30 percent cuts. The decrease is triggered by the sustainable growth rate (SGR) formula that pays doctors less in Medicare reimbursement when program costs outpace inflation. The House would have to pass the temporary fix. "The SGR formula has triggered rate decreases going back to 2003, but each time Congress has postponed them with a 1-year 'patch.' However, the difference between targeted and actual spending on physician services accumulates from year to year, making the next year's pay cut even bigger." Doctors have called for Congress to scrap the SGR formula, which "would not only avert the deep pay cut but also retire years of SGR 'debt.' However, the longer Congress waits to do so, the more debt there is to retire." (Lowes, 2/1).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

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