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