Medical News: New Bill Pushes Medicare Pay Cuts Out to 2014 - in Practice Management, Reimbursement from MedPage Today
New Bill Pushes Medicare Pay Cuts Out to 2014
By Emily P. Walker, Washington Correspondent, MedPage Today
Published: May 21, 2010
WASHINGTON -- Doctors would be spared from cuts in Medicare reimbursement until 2014 under a new bill that Congress is expected to take up before Memorial Day.
The bill -- known as the American Jobs and Closing Tax Loopholes Act of 2010 -- would enact tax cuts and extend a number of expired federal programs. It would also stave off a 21% cut mandated by the sustainable growth rate (SGR) formula, according to an outline of the bill, released Thursday by Senate Finance Committee Chairman Max Baucus (D-Mont.) and House Ways and Means Committee Chairman Sander Levin (D-Mich.).
Lawmakers appear to have abandoned a plan that was discussed earlier in the week to stall the cuts for five years.
The SGR was originally designed to match increases in physician payments under Medicare to the growth in the gross domestic product (GDP). The formula has called for reductions in Medicare payments for years as medical costs have inflated far more quickly than the GDP. Every year, at the last minute, Congress has postponed the cuts.
Under the bill, physicians who treat Medicare patients would receive "reasonable updates" for the rest of 2010 and all of 2011. In 2012 and 2013, "rates would continue to increase if spending growth on physician services is within reasonable limits."
While it's not clear how much the rates could be increased, the rates won't be reduced in 2012 and 2013, according to the outline of the bill.
Primary and preventive care doctors would see an extra, unspecified reimbursement.
The Congressional Budget Office is currently estimating the cost of the 3.5-year "doc fix."
But come 2014, physician reimbursements would again be on the chopping block. By then, the amount mandated to be cut under the SGR would be greater than 21%. Each time the cut is pushed down the road, the amount that physicians should be nicked -- according to the formula -- gets bigger and bigger.
The American Medical Association (AMA), which has long advocated for full repeal of the SGR, said the delay would provide some temporary relief. However, the group's president, James Rohack, MD, said the AMA is "deeply disappointed" that Congress has given up on a permanent fix.
"Lawmakers must realize that the underlying policy problem will return larger than ever in 2014," Rohack said in a statement. "Future Medicare cuts will severely undermine health system reform initiatives that aim to optimize the quality of patient care as physicians find they cannot afford to participate in Medicare."
The American College of Cardiology (ACC) echoed similar sentiments.
"Four years of positive updates will provide physicians with the stability needed, while we look at real ways for true payment reform and eliminating the need for the SGR," said ACC President Ralph Brindis, MD, MPH, in a statement.
The American Hospital Association (AHA), meanwhile, objected to a provision in the bill that would clarify the so-called "72 Rule," which states that all services provided for Medicare patients within 72 hours of a hospital admission are billed on one claim.
The bill would prevent hospitals from unbundling those services to receive additional Medicare payments.