Practice Economics

Congress poised to vote on 3-month SGR patch



WASHINGTON – Congress is preparing to vote on a proposal that would give physicians a temporary 3-month reprieve from the 20% Medicare pay cut that’s due to take effect on Jan. 1.

The proposal was quickly attached to legislation federal budget legislation that would also ameliorate some of the automatic, across-the-board spending cuts known as sequestration.

The House is scheduled to vote on the budget measure before it leaves for a month-long recess on Dec. 13. It is expected that the "doc fix" proposal could be voted on within the same time frame; however, it may not get support of the full House, even though there is bipartisan consensus to replace the Sustainable Growth Rate formula.

Rep. Michael C. Burgess

At a House Rules Committee hearing on Dec. 11, Democratic leaders said that they would not support the temporary SGR patch unless Republicans agreed to also vote on restoring unemployment compensation benefits for 3 months. Those benefits are due to expire at the end of December for 1.3 million Americans.

"I’m not sure that Democrats can vote for a package that adds SGR, which we support, but does not allow us to address long-term unemployment," said Rep. Nita Lowey (D-N.Y.).

The SGR amendment would increase physician fees by 0.5% for January-March 2014 and encourage Congress to keep working on a new, permanent Medicare fee system teamed with reduced administrative burdens and timely feedback on performance and to develop new payment models.

The temporary fix would be paid for by adjusting disproportionate share payments for hospitals, according to Rep. Michael Burgess (R-Tex.), an ob.gyn. who serves on the Rules Committee. The payment mechanism is noncontroversial, he said in an interview.

Physician groups have said that they would support a short-term fix, provided lawmakers continue working on a permanent repeal of the SGR.

"This is simply a pathway," Dr. Ardis Dee Hoven, president of the American Medical Association, said in an interview. "We want to keep up the momentum to get the SGR repealed. We recognize that it’s going to take a little more time."

Dr. Molly Cooke, president of the American College of Physicians, agreed. "This measure will allow Congress time to complete work early next year on comprehensive legislation to repeal the Medicare SGR formula," she said in a statement.

The Senate Finance Committee and the House Ways and Means Committee are both meeting to vote on proposals to permanently replace the SGR on Dec. 12.

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