Lawmakers close in on 'cease-fire' budget deal

Lawmakers are close to finding accord on a budget that would undo only a few parts of the government cuts known as "sequester." In addition, the proposed budget wouldn't lower the debt or change the costs involved with health care programs in addition to leaving other programs intact.

The Washington Post: Budget Deal Expected This Week Amounts To A Cease-fire As Sides Move To Avert A Standoff
House and Senate negotiators were putting the finishing touches Sunday on what would be the first successful budget accord since 2011, when the battle over a soaring national debt first paralyzed Washington. The deal expected to be sealed this week on Capitol Hill would not significantly reduce the debt, now $17.3 trillion and rising. It would not close corporate tax loopholes or reform expensive health-care and retirement programs. It would not even fully replace sharp spending cuts known as the sequester, the negotiators' primary target (Montgomery, 12/8).

The Wall Street Journal: Congress Readies A Year-End Dash
Because Republicans have refused to raise taxes and Democrats have declined to consider major cuts to Medicare or other entitlement programs, any deal is likely to mitigate only a modest chunk of the sequester. To permit spending to rise above levels set in 2011, lawmakers would need to agree on ways to trim the federal budget deficit elsewhere, potentially by increasing fees for airport security and federal guarantees of private pensions. An agreement would mark a rare moment of bipartisan accord brokered without the specter of a government shutdown or financial chaos. However, even a deal reached by two lawmakers popular within their own parties would still have to secure the support of a GOP caucus unafraid to buck its leadership and a Democratic caucus concerned about other expiring programs. In recent weeks, Democrats have pushed to extend emergency benefits for the long-term unemployed past their Dec. 28 expiration, but Mr. Durbin said Sunday he didn't expect it would become a make-or-break issue in the budget talks (Peterson and Crittenden, 12/8).

Lawmakers are also contemplating a change in how Medicare pays doctors, and a group of senators voice their support for a set of rule exemptions allowing doctors to self-refer for some in-office procedures --

JAMA: Fixing The (Un)Sustainable Growth Rate Formula: Shifting From Volume To Value
Although much media coverage around health care reform recently focused on the Obamacare rollout, another profound but far less publicized change could be coming. Congress is closer than ever to correcting the sustainable growth rate (SGR) formula, an ill-conceived policy that annually threatens physicians with indiscriminate cuts in fees to control Medicare spending (Sanghavi, O'Shea and McCelallan, 12/6).

Medpage Today: Docs In Senate Back Stark Law Exemptions
The physician members of the Senate wrote to congressional leaders this week backing the current Stark Law exemptions for in-office self-referrals. Sens. Tom Coburn, MD (R-Okla.), John Barrasso, MD (R-Wyo.), Rand Paul, MD (R-Ky.), and John Boozman (R-Ark.) said they support physicians referring for services such as radiation therapy, diagnostic imaging, pathology, and physical therapy within their respective practices. The Stark Law prohibits physicians from making self-referrals for certain services but allows self-referral for advanced diagnostic imaging, radiation therapy, anatomic pathology, and physical therapy (Pittman, 12/6).