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Bill on Payroll Tax, ‘Doc Fix’ Clears Congress, Heads to Obama’s Desk

Today, the Senate voted 60-36 in favor of legislation (HR 3630) that would extend the payroll tax cut, continue unemployment benefits and delay scheduled cuts to Medicare physician reimbursement rates, Politico reports. The vote comes less than an hour after the House voted 293-132 to approve the measure.

The bill now heads to President Obama, who has promised to sign it "right away" (Min Kim, Politico, 2/17).

Conference Committee

All but three members of the conference committee charged with developing the agreement signed the 270-page measure on Thursday.

Republican Sens. Jon Kyl (Ariz.), Mike Crapo (Idaho) and John Barasso (Wyo.) did not sign the agreement because they were "largely left out of the final phase" of negotiations between Sen. Max Baucus (D-Mont.) and Rep. Dave Camp (R-Mich.), according to the Post (Kane/Pershing, Washington Post, 2/16).

Details of the Package

The final agreement includes a 10-month "doc fix," which would allow Medicare to maintain current physician reimbursement rates, delaying a 27.4% reduction in fees set to start on March 1. To fund the $18 billion doc fix, the agreement includes several health-related offsets that would save $21.2 billion over a decade (Reichard, CQ HealthBeat, 2/16).

The agreement would cut:

  • $5 billion from the prevention and public health fund created by the federal health reform law;
  • About $4.1 billion in Medicaid payments to hospitals with a disproportionate number of uninsured patients (AP/U-T San Diego, 2/16);
  • Payment rates for clinical laboratory services by 2% in 2013, to save an estimated $2.7 billion over a decade (Zigmond, Modern Healthcare, 2/16).
  • $6.9 billion in "bad debt" payments to hospitals when Medicare beneficiaries do not pay for services (CQ HealthBeat, 2/16); and
  • $2.5 billion in Medicaid funding to Louisiana, which received increased funding from the overhaul (AP/U-T San Diego, 2/16).

Physicians Criticize Committee for Not 'Solving' SGR

Physicians' groups banded together and issued a joint statement to criticize the committee for failing to permanently repeal the sustainable growth rate formula by using war savings.

The American Academy of Family Physicians, American College of Physicians, American College of Surgeons, and American Osteopathic Association said the agreement "neither solves, nor moves us closer to solving, the Medicare physicians payment crisis" (Fox, National Journal, 2/16).

Rep. Allyson Schwartz (D-Penn.) said she will continue to work to repeal the SGR and indicated that some Republicans have privately told her they would support using war savings (CQ HealthBeat, 2/16).

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