Medicare physician payment cuts could cost millions more in reprocessing

Politico reports that the fight over a "doc fix" — fixing the Medicare reimbursement rate for doctors — is "straining not just doctors but also House-Senate relations" and could cost taxpayers millions of dollars. "Having waited for weeks in hopes of a stay, the Centers for Medicare & Medicaid Services, or CMS, is now enforcing a 21 percent cut in physician payments, and an estimated 50 million claims, held back since June 1, will be the first affected." Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi don't agree on the legislation, holding up a temporary fix to reimbursement rates. Last Friday, the Senate passed a temporary six-month fix to the reimbursement rate, and while "Pelosi remains committed to reversing the cut [she] was caught off guard last week when Reid suddenly opted to pull the Medicare issue out of a jobs and economic relief bill on which the two leaders have been working for months. Clearly annoyed, the speaker has not yet committed to taking up the Senate's Medicare fix when the House returns Tuesday evening" (Rogers, 6/22).

The Associated Press: Pelosi has said her chamber won't vote on the Senate version unless it includes "elements of the Democrats' jobs agenda. … The move by the California Democrat appears aimed at pressuring the Senate to break a logjam on long-sought legislation to extend unemployment benefits and give money to states to help them avoid additional layoffs and furloughs. That bill is stuck on the Senate floor because of a GOP filibuster." The Senate bill would provide a 2.2 percent pay boost to doctors at a cost of $6.5 billion "paid for with a series of health care and pension changes that Democrats and Republicans agreed to" (Taylor, 6/22).

Roll Call: Reid "is continuing to negotiate with a handful of moderates in both parties to try to craft a compromise that would result 'in the strongest bill possible and still get 60' votes, a senior Democratic aide said. But that appears to be easier said than done, and if a deal does not look likely in the next day or two, Reid may move on to one of the many other less controversial items languishing on the agenda." Though Democrats are focusing on winning support for the bill from Republican and Democratic moderates, the way forward is unclear. Even after separating out the Medicare payment issue, "Reid remains at least four votes shy" of being able to pass the jobs bill that also includes an extension of increased Medicaid funding for states (Stanton, 6/22). 

Roll Call, in a separate story, notes that Reid rejected a GOP proposal as a way forward. "Shortly after the Senate came into session Monday afternoon, the Nevada Democrat objected to a proposed unanimous consent agreement by Minority Leader Mitch McConnell (Ky.) for a fully paid for, 30-day extension to unemployment insurance benefits and a set of popular tax breaks" (Stanton, 6/21).

Meanwhile, news outlets indicate how doctors will feel the pinch as the Medicare pay fix awaits final action. 

Forbes, in an analysis, says that the checks to doctors that reflect a pay cut are already in the mail, because the House hasn't taken up the temporary fix. "The payments will eventually be reprocessed, but the cash-flow problems are very real. Every time Congress has to redress the payment problem, they put a temporary hold on payments. In this case there was both a temporary hold, and then a reduced payment" (Lipson, 6/22).

Pacific News Center: Physicians even as far away as Guam are being affected by the cut. "If health care providers want to be covered 100 percent, they have to resubmit their claim forms, plus fork out the added costs of paperwork for both providers and taxpayers" (Tyquiengco, 6/22).