POLICY:

Hope fades for long-term solution from Congress

Time running out for long-term solution to SGR problem

Fears are growing that another twomonth temporary patch for Medicare physician pay rates is increasingly possible as congressional negotiations on a long-term solution to the problem appeared deadlocked.

A bipartisan congressional conference committee aims to avert an automatic 27.4% cut by Medicare’s sustainable growth-rate formula for physicians on March 1 when a two-month freeze at last year’s rates expires.

The two parties have locked into opposing approaches, according to congressional sources, with Republicans generally favoring a two-year extension of the current rates and Democrats pushing for elimination of the payment formula and its scheduled cuts.

But the primary obstacle to any movement on the issue, members of Congress and other sources said, is the stark differences in ways proposed to pay for either approach. Democrats primarily want to use a one-time budget offset of “savings” stemming from the end of the Iraq War, while Republicans continue to push budget cuts, including at least $44.6 billion in 10-year healthcare cuts.

“I think it needs to pass the straight-face test,” House Speaker John Boehner (R-ohio) said in a news conference last week about proposed funding alternatives. “The fact is, we are going to spend less in our war efforts