Lame-Duck Congress Not Likely to Pass Physician Payment Reform

Don't expect the lame-duck session of Congress that opened Nov. 13 to reform the Medicare physician payment system. Instead, the Nov. 7 election results likely will convince federal lawmakers to pass temporary continuation of the existing payment rate and policy, said Kevin Burke, director of the AAFP Division of Government Relations.

He and Jennifer Duffy, editor of the Cook Political Report, reviewed the Nov. 7 election and its impact on physician payment reform and other health-related issues during the AAFP's State Legislative Conference here Nov. 10-11.

The mid-term election "eviscerated" the Republican majority and "so the lame-duck question is whether Republicans want to resolve issues left over or kick them down the road" and hand the challenges off to Democrats, said Burke.

According to postelection reports in Congressional Quarterly's CQ Healthbeat, most members of Congress expect the lame-duck session to pass a continuing resolution that temporarily continues 2006 payment levels or an appropriations bill that would be effective for a year. One remote concern is that a continuing resolution that maintains current payment levels could attempt to preserve current payment policy. That would mean changes to evaluation and management code relative value units also would be stalled, according to Burke.

"If we have a short session and a continuing resolution, it will be hard to solve the payment issue" in the lame-duck session, said Burke. "If we have a long session, we have a better chance for an omnibus appropriations bill, and we could have more time" to work for more comprehensive payment reform.

The election, which gave control of both the House and the Senate to Democrats, shows voters rejected much of the Bush administration's priorities since the 2004 elections, said Duffy.

"Voters feel insecure about the cost of health care, about how to send their kids to college," said Duffy. "It wasn't that President Bush didn't come into his second term with no ideas; it was that the voters hated them -- the ideas like privatizing Social Security."

If the 109th Congress, in its lame-duck session, fails to override the 5 percent physician payment cut scheduled for 2007, the Academy will work with the 110th Congress for comprehensive Medicare physician payment reform and make that solution retroactive to January, according to Burke.