SGR ban­dage

GOP leg­is­la­tion of­fers tem­po­rary doc fix

Modern Healthcare - - THE WEEK IN HEALTHCARE - Jes­sica Zig­mond

House Repub­li­cans late last week in­tro­duced a bill that may make the na­tion’s physi­cians breathe a lit­tle eas­ier about their Medi­care pay­ments, but could leave hos­pi­tals gasp­ing that they’re be­ing short­changed to make that hap­pen.

In leg­is­la­tion that would ex­tend a pay­roll tax hol­i­day and re­form the un­em­ploy­ment in­sur­ance pro­gram, House GOP mem­bers in­cluded sev­eral health­car­ere­lated pro­vi­sions, in­clud­ing one that would avert the loom­ing 27.4% cut in Medi­care pay­ments to physi­cians and pro­vide a 1% pay­ment in­crease to doc­tors in 2012 and 2013.

The two-year fix—es­ti­mated to cost $38.9 bil­lion—is the long­est tem­po­rary mea­sure that Congress has ap­proved since 2004 to pre­vent dras­tic pay­ment cuts to doc­tors that are called for un­der the sus­tain­able growth-rate, or SGR, for­mula. The move is in­tended to give fed­eral law­mak­ers more time to find a per­ma­nent so­lu­tion to how doc­tors are paid through the Medi­care pro­gram, ac­cord­ing to a summary from the House Ways and Means Com­mit­tee.

“I think this is a pos­i­tive move,” Rep. Tom Price (R-GA.), a physi­cian who serves on that panel, told Modern Health­care hours be­fore the bill was in­tro­duced.

“It’s not all that I would want,” he con­tin- ued. “I think it’s a com­mit­ment on the part of com­mit­tees of ju­ris­dic­tion and lead­er­ship to come to a re­solve of this is­sue that has re­ally been a thorn in the side of ev­ery sin­gle in­di­vid­ual pro­vid­ing care.”

Ac­cord­ing to the com­mit­tee’s summary, the bill would ex­tend four Medi­care-re­lated poli­cies that are set to ex­pire. Those in­clude main­tain­ing the add-on pay­ment in­creases for ground am­bu­lance ser­vices and ex­tend­ing the Qual­i­fied In­di­vid­ual, or QI, pro­gram, which pro­vides as­sis­tance to low-in­come se­niors for their Medi­care Part B premium. It would also ex­tend the physi­cian work ge­o­graphic ad­just­ment, which would ex­tend un­til De­cem­ber 2012 the cur­rent floor that is used to cal­cu­late the por­tion of Medi­care physi­cian pay­ments that ac­counts for the ge­o­graphic area where a physi­cian prac­tices. And it would also ex­tend the out­pa­tient ther­apy caps ex­cep­tions process.

Ab­sent con­gres­sional ac­tion, the ther­apy caps ex­cep­tions process is set to ex­pire and Part B out­pa­tient ther­apy ser­vices—pro­vided by non-hos­pi­tal providers—would be capped at $1,889 start­ing in 2012. A pro­vi­sion in the Mid­dle Class Tax Re­lief & Job Cre­ation Act of 2011, as the pro­posed leg­is­la­tion is called, would

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.