House Democrats Will Not Take Up Senate’s Stand-Alone ‘Doc Fix’
On Monday, House Democratic leaders said they would not take up the Senate's stand-alone measure (HR 3962) to postpone for six months a scheduled 21% cut to physicians' Medicare reimbursements, CQ Today reports.
After the measure cleared the Senate on Friday, House Speaker Nancy Pelosi (D-Calif.) said that she saw "no reason" for the House to approve the bill (Ethridge, CQ Today, 6/21).
The $6.5 billion measure emerged as a compromise between Senate Democrats and Republicans, after debate on the larger, House-approved "extenders" legislation (HR 4213) -- which included the "doc fix" -- stalled in the Senate over some members' concerns with the bill's cost, projected effect on the federal deficit and lack of adequate offsets.
Senate leaders on Thursday agreed to remove the doc fix proposal and offer it as a stand-alone measure, which would provide a 2.2% payment increase to Medicare physicians through November. The provision would be fully offset with two revenue-raising provisions (California Healthline, 6/21).
After the Senate approved the doc fix by unanimous consent, Pelosi said the proposal fell short of the extenders bill's objective to create jobs. The standoff between the two chambers also appears certain to further impede any plan to delay the 21% cut in doctors' payment rates that took effect on Friday (CQ Today, 6/21).
Medicare Payment Cut Threatens House-Senate Relations
According to Politico, debate over how to address the scheduled Medicare payment cut also appears to be straining the relationship between the two chambers.
Although House and Senate leaders and their respective tax-writing committees worked together on the extenders bill for months, it appears that House Democrats received no notice that the doc fix would be separated from the bill, Politico reports.
Aides to Senate Majority Leader Harry Reid (D-Nev.) blamed the Senate impasse regarding the extenders bill on Thursday's Republican-led filibuster.
A Reid representative said, "[That] left us with a choice to do nothing or pass a stand alone after the House had [adjourned for the weekend]," adding, "We chose the latter." Reid's office declined to comment on whether Reid had consulted with Pelosi about the doc fix compromise (Rogers, Politico, 6/21).
Senate Leadership Continues To Seek Votes; Reid Might Drop Bill for Now
On Monday, Democratic leaders continued to express hope that they would secure enough votes to approve the extenders bill.
Senate Finance Committee Chair Max Baucus (D-Mont.) acknowledged that they still did not have the 60 votes required to advance the package, but added that he "had some ideas" on how to garner the votes (CQ Today, 6/21).
Meanwhile, Reid continued his attempts to secure the four votes necessary to pass the bill. However, Reid also is considering temporarily dropping the bill in favor of other less contentious items on the Senate's agenda, Roll Call reports.
Reid on Monday criticized the Senate's inaction on the bill and rejected a GOP proposal for a 30-day delay to the 21% physician Medicare payment cut. Reid dismissed the proposal as a political ploy and an attempt by Republicans to show "fiscal austerity" when they do not hold power in Congress (Stanton, Roll Call, 6/22).
Retroactive Solution Could Costs Millions
If Congress acts to retroactively address the 21% cut to Medicare physician reimbursement rates, which took effect June 1, the federal government might face millions in additional costs to reprocess claims, Politico reports.
CMS began enforcing the cut on Friday, and will process an estimated 50 million claims the agency had been holding since June 1. CMS had twice announced that it would delay processing the claims, in the hope that Congress would address the payment cut.
With the cut, physicians now will be reimbursed about $8 less for a typical office visit than in 2007. However, if the cut is reversed, CMS has estimated that it will cost the agency 30 cents per claim, or about $15 million for the initial 50 million claims (Politico, 6/22).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.