Short-term doc fix leaves long-term question
With short-term doc-pay fix in place, push is on for long-term solution
The highlight for providers of the hard-fought budget and tax battles in Congress in the waning days of 2011 was the delay of deep cuts to Medicare physician pay, if only for a mere two months. But the fight over how the government will pay for a longer-term solution will begin anew as the expiration of the twomonth patch approaches.
Physician advocates publicly scolded Congress but were privately relieved, several told Modern Healthcare, when a last-minute taxcut bill included a two-month postponement of a scheduled 27.4% Medicare payment cut that was supposed to occur Jan. 1.
The final deal, congressional sources said, was intended to give legislators time to find compromises on how to fund a one- to two-year extension of the current Medicare rates. The need for the short-term deal became clear as the calendar ran out on the year and Republicans and Democrats remained far apart on how to pay for a longer extension.
That division was illustrated by the very different approach to the Medicare pay issue included in the version the House of Representatives passed several days before agreeing to the two-month approach backed by the Senate. The House bill would have averted the physician pay cut for two years and provided a 1% payment increase to physicians in 2012 and 2013. The House bill also included two-year extensions of several Medicare provisions set to expire (the final law extended them for two months), such as extending the Qualified Individual Program, which provides Medicare Part B premium subsidies to low-income seniors.
But Republicans paid for the $38.9 billion two-year physician fix with cuts that drew objections from other providers, such as $17 billion in reduced payments to hospitals and an $8 billion cut from the Patient Protection and Affordable Care Act’s prevention and public health fund.
The offsets led several hospital advocacy groups to mobilize members to pressure Congress to reject the House-passed approach to preventing the physician payment cuts.
For example, the American Public Health Association launched a letter campaign and in-person Capitol Hill visits from its members in mid-december specifically to oppose cuts in the prevention fund. “Chronic disease spending makes up a significant majority of our skyrocketing healthcare costs, and the Prevention Fund presents an opportunity to rein in our healthcare spending by reducing the rate of many leading chronic diseases,” the group said in a Dec. 13 letter to members of Congress. “Diverting any portion of this funding would derail current public health activities in communities and states across the country and would leave American families