GOP legislation offers temporary doc fix
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