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Senate passes 'doc fix' as pay cuts go into effect

by Brendon Nafziger, DOTmed News Associate Editor | June 21, 2010
Another freeze on
cuts to physician pay
In keeping with a tradition of last-minute congressional reprieves, the Senate agreed to freeze a Medicare pay cut to doctors the day it was scheduled to go into effect.

On Friday, the Senate unanimously decided to pass a nearly six-month freeze of a 21.3 percent cut to physicians payments from Medicare, just as the Centers for Medicare and Medicaid Services resumed processing payments after an 18-day hold.

The bill, believed to cost around $7 billion, will also boost Medicare payments 2.2 percent through November.

Passage of the bill comes too late to stop the cuts from going into effect, as the legislation needs to be approved by the House of Representatives, on recess until next week. However, the bill is retroactive from the beginning of June, when the cuts technically first started.

To give Congress a chance to pass cut-freezing legislation, the CMS instructed its contractors to hold claims until June 18.

Friday's vote comes after around seven weeks of partisan wrangling on the Hill amid concern over the nation's ballooning $13 trillion deficit.

The "doc fix" passed Friday was carved out of a larger benefits bill passed by the House in May but stalled in the Senate as both Republicans and moderate Democrats balked at the nearly $80 billion the legislation would add to the deficit.

"Isn't it time we stopped burdening our children and grandchildren with massive debt?" John McCain (R-Ariz.) asked Thursday in the Senate while supporting a rival amendment sponsored by Sen. John Thune (R-S.D.).

The deal for the separate "doc fix" bill came after a late-night hash session Thursday between Senate Finance Chairman Mac Baucus (D-Mont.) and Charles Grassley (R-Iowa), the highest-ranking Republican on the finance committee, according to the Washington daily The Hill. Before they met, a slimmed down version of the benefits bill, which included the "doc fix," failed to reach the 60 votes necessary Thursday, as required by Senate rules.

Essential to its passage, the separate 'doc fix' will be nearly completely offset, The Hill reported.

The late, temporary freeze of pay cuts did not mollify the American Medical Association, the doctors group which has long called for a permanent end to the cuts called for by the sustainable growth rate.

"This is no way to run a major health coverage program," AMA President Dr. Cecil B. Wilson said in a statement. "It is astounding that Congress has let seniors down through their inability to deal with this problem on time and in a responsible fashion."

Nearly one out of five doctors, and one-third of primary care physicians, have limited the number of Medicare patients they see, Dr. Wilson said, primarily because of the threat of pay cuts and low reimbursement.

In Congress, the Democrats blamed Republicans for dragging their heels on the legislation.

"Remember, Medicare reimbursements are not just for Medicare patients," Sen. Harry Reid (D-Nev.) pleaded. "Most [private insurer] reimbursement in our country is based upon Medicare levels."

But the Republicans accused Democrats of deliberately leaving out a permanent solution to the Medicare cuts from the health reform legislation passed this spring in order to hide the true cost of reform.

"It's kind of hypocritical for us to be blamed for the delay in the "doc fix," when that was the assumption that there would be a 21 percent cut in the selling of Obamacare to the American people," McCain said.