U.S. Legislative Leaders Float Plans to Rework Doctors’ Medicare Pay
Senate and House leaders and committee staffers have met with members of President-elect Barack Obama's health care team to discuss reworking the Medicare payment formula, CongressDaily reports.
Legislative leaders have raised the possibility of cutting $100 billion from the cost of permanently fixing Medicare physician payments by eliminating drugs administered by doctors from the payment formula.
Under the sustainable growth rate formula, physicians face a Medicare payment reduction annually, but Congress typically passes a measure to avoid the cut.
Next year, lawmakers hope to permanently eliminate the cuts, possibly by rebasing the SGR formula.
The plan currently being touted by lawmakers would remove the cost of physician-administered drugs from SGR -- a change long-supported by doctor groups -- and "save Congress the task of finding a way to pay for the move," CongressDaily reports.
Removing physician-administered drugs from SGR would reduce the estimated $300 billion cost of permanently forgoing physician cuts by one-third.
According to sources familiar with the issue, the best way to remove the drugs from the formula would be either by executive order or a CMS rule.
Congress plans to address the fix as part of an effort aimed at overhauling the health insurance system next year (Edney, CongressDaily, 12/9). 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.