Friday, the Senate — in a rare stroke of bipartisanship — voted by unanimous consent to reverse the 21 percent SGR cut and provide positive updates of 2.2 percent through November 2010. The legislation is fully paid for by offsets in other spending programs.
Unfortunately, though, the cut remains in effect and claims are being processed at reduced rates, because the House of Representatives has recessed for the weekend and won’t be back until Tuesday. At that time, I expect that the House will pass the Senate’s six-month reprieve and Medicare will make doctors “whole” for the period of time that the cut was in effect.
Not that any of this is a cause for celebration. In the meantime, claims still are being paid at reduced rates, creating havoc for physicians and patients. Kicking the can down the road for another six months doesn’t get us any closer to a permanent solution. It doesn’t lower the overall cost, now estimated at over $200 billion, to dig out of the SGR hole. It doesn’t provide the stability and reliability that physicians and patients need to view Medicare as a trusted partner. It does mean that we will be back again, this summer and fall, fighting to forestall another double-digit cut. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
This is something I haven’t seen reported on elsewhere, but according to the ACEP 911 Legislative Network Weekly Update, there was an interesting twist in the Democrats’ proposed SGR fix:
The latest plan increases physician payments by 1.3% for the remainder of this year and by an additional 1% in 2011. In 2012 and 2013, physician services would be separated into two categories, or “buckets.” One bucket would be for E&M services (including emergency department, primary and preventive care) and the other group would include all other services. The E&M bucket would increase at the same rate as the U.S. gross domestic product (GDP) plus 2%, while the other group would receive a payment increase of GDP plus 1%.After 2013, the payment formula would revert back to the current SGR formula, which means physicians would face cuts in the range of 30-35% unless Congress intervenes.
So it’s another temporary fix, kicking the can past the next presidential election. But it’s the first one I have seen that attempts to address the gross disparity in reimbursement for procedural services compared to the cognitive services. It bypasses the RUC and almost every other existing mechanism for determining reimbursement under the MPFS.
I’m not sure what happened with this proposal. I don’t think it was in the version of legislation the House passed, so I think it might be dead. But the situation is so in flux that who really knows? If nothing else, it’s an encouraging sign that policymakers know the problem exists and are willing to throw out possible solutions. This one may be dead, but it’s a good start.
*This blog post was originally published at Movin' Meat*
Senators visited their districts Friday and again today, so the earliest they could vote on the doc fix is tomorrow (6/15) — the day the 21.3 percent reimbursement cut takes effect.
Slowing down the process are the numerous amendments. For example, the duration of the fix is still being negotiated. And there are amendments such as redefining what makes up a rural health district. In California, some rural areas are seeing urban levels of patient demand, but giving more money to these counties is being seen as a kickback akin to others that were proposed during healthcare reform. (Part B News, The Hill)
*This blog post was originally published at ACP Internist*
By Stanley Feld MD, FACP, MACE
Physicians in practice work hard and have little time for political and legal trickery. They assume their leadership will look out for their interests while they take care of patients.
The problem is that physicians do not have effective leadership, explaining the difficulties practicing physicians have every day with the healthcare insurance industry, hospital administrators, the government and the threat of liability. Most physicians are caring professionals who are not looking to rip off anyone. Physicians do expect reasonable compensation commensurate with their training, level of expertise and level of responsibility.
I recently presented a physician income survey to a group of corporate executives. The executives were astonished by the level of physician income relative to their level of responsibility.
The unanimous reaction of these corporate executives was the average physician’s income was that of a low mid-level manager. It is true some practice specialties earn more but the average income of practicing physicians is not commensurate with their knowledge and responsibility. Read more »
*This blog post was originally published at Repairing the Healthcare System*