February 16, 2012

Political debacle with “doc fix” continues…

BY Dr. Keith J. Kaplan

Now the "doc fix" to address permanently the SGR formula is getting bundled with payroll and unemployment monies, or "programs" as they are sometimes referred to.  Conveniently, Congress can stall the issue further, "kick the can down the road", respond to physician advocates by not repealing the SGR once and for all and continue to add to uncertaintly in the healthcare morass.  But do not fret providers and patients, Congress will take a holiday of their own after the vote Friday paid for by our taxes.

Really good thing the government is not involved with healthcare and a payor system until the Healthcare Law goes into full effect…

The deal on the Medicare "doc fix" received widespread coverage, both in print and online, but mostly in the context of it being part of a larger deal involving extensions of both the payroll tax holiday and unemployment benefits. The AP (2/16, Taylor) reports congressional negotiators worked "into Wednesday night ironing out final details of an agreement to extend a cut in the payroll taxes paid by most Americans. The legislation also would renew jobless benefits for millions more."

The Washington Post (2/16, Kane) says the plan "includes a temporary fix for Medicare's payment plan, which, left unchecked, would lead to a 27 percent drop in fees paid to doctors who treat elderly patients."

In a front-page story, the New York Times (2/15, A1, Steinhauer, Subscription Publication) reports, "A vote on the measure would most likely happen by Friday, when Congress is set to recess for a week."

Deal Would Include $11.6 Billion In Cuts To Healthcare Law. CQ (2/16, Reichard, Subscription Publication) reports, "The tentative agreement House and Senate negotiators reached on Medicare physician payments would block cuts through 2012 and offset part of the cost with $11.6 billion in cuts to the health care law, a GOP aide said Wednesday." The federal health "law cuts would take $5 billion from the $15 billion fund created under the measure to boost programs to prevent chronic diseases, the aide said." Meanwhile, "Medicaid spending for hospitals that treat a disproportionate share of low-income patients would be cut by $4 billion."

The Kaiser Health News (2/16, Carey) "Capsules" blog reports that additionally, "Louisiana would not receive $2.5 billion in additional Medicaid funds included in the health law, according to" the "GOP aide." Lawmakers also "plan to take $9.6 billion from areas that include payment cuts for clinical laboratory services and Medicare 'bad debt,' payments Medicare makes to hospitals and nursing homes when patients cannot pay for their medical care."

Medscape (2/16, Lowes) reports, "Assuming that both the House and the Senate approve the measure, physicians could face another doc-fix drama in the lame-duck Congress that follows the November 6 general election." As of "January 1, 2013, the scheduled Medicare pay cut would top 27.4%, as calculated by the program's sustainable growth rate (SGR) formula." MedPage Today (2/16, Walker) also covers the story.

 CQ (2/16, Reichard, Subscription Publication) reports that "despite concerted efforts by Sen. Jon Kyl, R-Ariz., to apply war savings, it appears that the latest temporary 'doc fix' to block Medicare physician payment cuts under the 'Sustainable Growth Rate' (SGR) physician payment formula without getting rid of the formula itself have come to naught." Some physician groups were critical of the move. In a statement, the American Osteopathic Association said, "It is troubling that Congress continues to operate the nation's largest and most influential health care programs on an ad hoc basis." Meanwhile, American Medical Association President Peter W. Carmel said, "We are deeply disappointed that Congress chose to just do another patch – kicking the can, growing the problem and missing a clear opportunity to protect access to care for patients."

Modern Healthcare (2/16, Zigmond, Subscription Publication) reports that in a statement, Dr. Susan Turney, president and CEO of MGMA-ACMPE, formerly the Medical Group Management Association, said, "We are deeply disappointed that Congress has missed a unique opportunity to repeal the SGR once and for all and instead has chosen political expediency over patients." Dr. Turney also said in the statement, "Group practices are telling us that this congressional decision exacerbates an already unhealthy environment that limits their ability to plan for the future and balance their practice's fiscal health with their desire to continue to serve Medicare beneficiaries."

 

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