Both the House and Senate have opted to address Medicare payments to doctors as part of the impasse over extending a payroll-tax cut set to expire at the end of the year. Congress is deadlocked over the tax, which has become the end-of-session vehicle for unrelated issues, including fees for Medicare, the U.S. insurer for those 65 and older and the disabled.
House Republicans aren’t planning to address physician fees in a separate bill, said Michael Steel, a spokesman for Boehner, in an e-mail. If the cut isn’t reversed, doctors would absorb the largest single decline in federal reimbursements in the history of the program, raising concerns physician will limit how many new Medicare patients they accept.
“Medicare patients should not become the collateral damage of a political battle,” said Joyce Rogers, senior vice president of AARP, the largest advocacy organization for the elderly. “Congress should pass legislation that reinforces doctors’ faith in the Medicare payment system and gives current and future Medicare beneficiaries the security of knowing that they can get the care they need.”
Time to Act
Medicare, in a statement sent to doctors and other health care providers yesterday, said it can use administrative tools to hold off on actually making payments at the lower rates for 10 business days, though Jan. 17. That would give Congress time to come back and act should the current effort fail entirely.
“We continue to urge Congress to take action to ensure these cuts do not take effect,” the statement said.
The American Medical Association, based in Chicago, has been coordinating lobbying by state medical associations and specialist societies against the cut. The group also ran TV and radio ads against the cuts.
“Waiting until the last week of the legislative session to address a problem that Congress knew was looming all year is not the way to conduct our nation’s business,” said Peter Carmel, the group’s president, in an e-mailed statement. “A permanent solution is the long overdue, fiscally responsible approach.”
Cardiologists have been moving from private practice to hospital work to insulate themselves from uncertainty over Medicare reimbursements, said Jack Lewin, chief executive officer of the American College of Cardiology.
“Doctors will go in and take care of heart attacks and life-threatening cardiovascular conditions for people with Medicare,” he said. “But elective things, chronic conditions, people will think twice about whether they want to do that because that’s how the financing goes. Patients will have less access to care.”
Stopping cuts to Medicare’s physician rates has become an annual ritual for Congress, which has faced the problem since the start of the last decade and passed short-term “fixes” that last for a year or six months. A permanent overhaul of the formula has been tough to come by, partly because of its $290 billion cost, according to the Congressional Budget Office.
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