Fix in the mix

1.2% SGR update on the ta­ble, five-year plan, too

Modern Healthcare - - The Week In Healthcare - Matthew Do­Bias

House and Se­nate ne­go­tia­tors have drafted a path­way for a five-year fix to the Medi­care physi­cian pay­ment for­mula that would give doc­tors a 1.2% raise for the bal­ance of 2010 with the prom­ise of more to come, health­care lob­by­ists say.

Un­der the re­vised pro­vi­sion, part of a broad pack­age of tax ex­ten­ders and con­tin­u­a­tions to sev­eral safety net health pro­grams, physi­cians would see a 1% in­crease in 2011. One year later, the sus­tain­able growth-rate pro­vi­sions orig­i­nally set out in the House-passed health re­form bill would kick in, ac­cord­ing to two health­care lob­by­ists with knowl­edge of the deal, and who spoke on con­di­tion of anonymity.

Orig­i­nally, joint ne­go­ti­a­tions be­tween mem­bers of the House Ways and Means Com­mit­tee and the Se­nate Fi­nance Com­mit­tee fo­cused on leg­is­la­tion passed by both cham- bers that would have frozen Medi­care pay­ments un­til the end of the year in an ef­fort to hold off a sched­uled 21.2% pay cut.

But in the plan cur­rently un­der ne­go­ti­a­tions, law­mak­ers are eye­ing a longer-term fix that would pre­vent fu­ture cuts from kick­ing in. Rep­re­sen­ta­tives for the two com­mit­tees de­clined to com­ment.

Though ne­go­ti­a­tions are fluid and could change, the physi­cian fix blue­print would es­sen­tially cre­ate two “buck­ets” of physi­cian ser­vices—one that in­cludes de­fined pre­ven­tive, eval­u­a­tion and man­age­ment vis­its and pri­mary care and an­other for all other physi­cian ser­vices.

For the first bucket, an in­fla­tion­ary update would be based on a gross do­mes­tic prod­uct of plus 2%. In the sec­ond bucket, the update

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