Senate Approves Stand-Alone ‘Doc Fix’, But Cuts Still Take Effect
On Friday, the Senate by unanimous consent approved a stand-alone measure (HR 3962) that would postpone for six months a scheduled 21% cut to physicians' Medicare reimbursements, temporarily ending a two-week impasse in the chamber over the broader "extenders" legislation (HR 4213), CongressDaily reports.
The $6.5 billion "doc fix" measure would provide a 2.2% payment increase to Medicare physicians through November. The cost of the bill would be fully offset with two revenue-raising provisions:
- The first would prohibit Medicare payments to hospitals for outpatient and inpatient services that are provided within 72 hours of a patient's admission. The so-called "72-hour rule" would save about $4.2 billion over 10 years; and
- The second would generate $2.8 billion by allowing companies to extend their pension fund obligations over a longer period, which would increase businesses' taxable income (McCarthy, CongressDaily, 6/18).
The "doc fix" was part of the House-approved extenders bill, but debate on the extenders legislation stalled in the Senate over some members' concerns with the bill's cost, projected effect on the federal deficit and lack of adequate offsets (Vaughan, Wall Street Journal, 6/18).
After Senate Democrats on Thursday failed to overcome a Republican-led filibuster against the extenders bill, Democratic and Republican Senate leaders reached a deal on the stand-alone doc fix compromise (California Healthline, 6/18). On Friday, the Senate approved the compromise measure by voice vote (Wall Street Journal, 6/18).
Physician Payments Move Forward With 21% Rate Cut
The approval of the doc fix compromise came too late to avert the 21% payment cut that took effect on Friday, Politico reports.
Earlier in the week, CMS announced that it would extend a freeze on processing physicians' Medicare claims through Thursday to give the Senate more time to approve the payment cut delay (Rogers/Haberkorn, Politico, 6/18)
Â On Friday, CMS sent a memo to congressional leaders explaining that Medicare contractors had been instructed to process claims dated June 1 or later with the 21% rate cut (Norman, CQ HealthBeat, 6/18).
The claims can be reprocessed if and when the doc fix compromise has been approved in both chambers and signed by President Obama. The House still has to approve the compromise measure, but members already had adjourned for the weekend. The House is expected to take the measure up this week (Politico, 6/18).
Pelosi Withholds Support for Bill
After the Senate approved the doc fix, House Speaker Nancy Pelosi (D-Calif.) said the measure was not enough and that it would not pass in her chamber, Roll Call reports (Hunter, Roll Call, 6/18).
The House-approved version of the extenders bill included a provision that would have postponed the scheduled 21% payment cut through end-2011, with small payment increases to physicians in 2010 and 2010.
A Pelosi spokesperson later said that the House would "review [the Senate's] legislation as we remain committed to ensuring that our seniors and veterans receive the care they deserve" (Wall Street Journal, 6/18).
'Extenders' Bill Still Stuck in Senate
Although the Senate has temporarily addressed physicians' Medicare reimbursements, the broader extenders bill is still delayed in the chamber, CQ Today reports. The package still contains other important health care-related provisions (Rubin, CQ Today, 6/18).
One such provision is the proposal to restore about $24 billion in additional federal Medicaid assistance to states through June 2011, which had initially been omitted from the House version, to lower the cost of the legislation (Cohn/McCarthy, CongressDaily, 6/21).
Senate Finance Committee Chair Max Baucus (D-Mont.) said the extenders bill still has a lot of momentum in the chamber -- despite strong disagreement among members with its cost and offsets -- and that it remains on the Senate's agenda this week (CQ Today, 6/18).
According to CongressDaily, it is not clear if, or when the legislation will finally advance to the Senate floor, but "time is tight for states" for states that absorbed the extra funding into their budget proposals for fiscal year 2011, which typically begins in July (CongressDaily, 6/21).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.