Congress Moves Closer to Passing Medicare Payment Legislation

House Leader Promises Vote By End of Month

November 19, 2010 03:40 pm News Staff

Although the U.S. Senate has passed a one-month extension of the current Medicare physician payment rate, the House, which has already recessed for Thanksgiving, will not approve the measure until it returns on Nov. 29. Passage of the bill is necessary to delay a 23 percent reduction in Medicare payments called for by the sustainable growth rate, or SGR, formula and scheduled to take effect on Dec. 1.

According to a statement( from House Majority Leader Steny Hoyer, D-Md., "Tonight the Senate passed a one-month extension of the current Medicare physician payment rates. It is my intention to schedule this bill for consideration when the House reconvenes on Nov. 29, so we can send it to the president's desk prior to the November 30 expiration date of current SGR relief."

AAFP President Roland Goertz, M.D., of Waco, Texas, said he was "disappointed that (Congress) did not go ahead and take care of things" before adjourning for the Thanksgiving recess. "But the Senate was considered the more difficult accomplishment," Goertz added, "and since they have acted, I think the House will follow suit."

Meanwhile, Sen. Max Baucus, D-Mont., the chair of the Senate Finance Committee, and Sen. Charles Grassley, R-Iowa, the ranking Republican member of the committee, vowed to pursue a year-long payment fix before the month-long SGR patch expires. Without congressional intervention, physicians face a further Medicare payment reduction on Jan. 1.

"We have advocated for exactly what Baucus and Grassley have asked for because it looks like we do not have an option to get a permanent fix in place at this time," said Goertz. "Hopefully a 12-month extension would allow enough time for Congress to find the offsets to create and discuss a much longer fix -- if not a permanent fix, which is our ultimate goal."

The AAFP, meanwhile, has emerged as a leading voice in urging Congress to pass legislation that would extend the current Medicare physician payment rate for at least the next 12 months and to then pass a longer-term measure that would include making the Medicare payment system more equitable by providing a payment differential for primary care.

In August, the AAFP unveiled a toolkit to help family physicians and their patients generate support for fixing the flawed payment system. Each of the documents in the toolkit calls for a permanent fix to the SGR and a positive payment differential for primary care physicians to better reward provision of primary care services. But each document conveys that message differently based on the target audience.

In the meantime, Goertz noted, "We will continue to fight for what is best for our patients and our members regardless of how long it takes to get a permanent payment fix in place."