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End of the "doc fix" era?

from AAGP

Now that Congress has returned from its five-week summer recess, it is anticipated that, prior to the end of this year, it will act on a bill that would block cuts to Medicare's physicians payments on Jan. 1. The question is whether lawmakers will pass a temporary fix, as they have for the past ten years, or whether they will finally make this the year they agree on a comprehensive solution.

House Energy and Commerce Committee members have made more long-term progress on a long-term growth rate measure than Congress has seen in years, although the bill's sponsors acknowledge that the legislation is far from finished. The House Ways and Means Committee and the Senate Finance Committee also plan to introduce their own bills this fall. Congress seems closer than ever to instituting a new Medicare payment system, but several obstacles stand in the way of getting a bill to the president's desk by the end of the year. If that fails, Congress will be pressed to come up with another short-term solution or physicians will see their payment rates reduced by approximately 25 percent on Jan. 1.

The Energy and Commerce bill, the only official measure so far, would repeal the sustainable growth rate formula and replace it with an enhanced fee-for-service system, while also allowing providers to opt out and participate in alternative payment models. The bill, approved unanimously by the committee in July, would first institute a five-year period of stable payments, to allow certainty while physicians adjust for the new payment models. After that, physicians would participate in either an enhanced fee-for-service system or in approved alternative payment systems. more


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