AGA Washington Insider

A policy blog for GIs

House “Doc Fix” Bill Freezes Payments for Two Years

The House Republican leadership has been crafting a year end “three-pack” bill that would provide a two-year 1 percent update in Medicare physician payments, extend the 4.2 percent payroll tax rate for one year and provide one year of jobless benefits. The so-called “doc-fix” would prevent the scheduled 27 percent cut in Medicare physician payments scheduled to go into effect on Jan. 1, 2012, and provide a 1 percent update for two years at a cost of $38.9 billion.

The costs would be offset in part by raising Medicare premiums on wealthy beneficiaries by 15 percent in 2017 and cutting prevention funds from the Patient Protection and Affordable Care Act (PPACA). The Republican package calls on the General Accounting Office (GAO) and the Medicare Payment Advisory Committee (MedPAC) to study the feasibility of aligning private payor quality and efficiency programs with Medicare. The language encourages GAO and MedPAC to consult with medical professional societies on their study.  

Republicans may bring this bill up for a vote next week as they have been whipping their members to secure the necessary 218 votes for passage. Reports have indicated that many conservative Republicans, particularly members of the freshman class, are opposed to extending the payroll tax and unemployment benefits. However, even if the House passes this “three-pack” bill, its fate is unknown in the Senate since Senate majority Leader Harry Reid, D-NV, and other Democrats oppose the offsets.

AGA is on Capitol Hill daily advocating that Congress prevent the 27 percent cut in physician reimbursements and provide a permanent solution to the Medicare physician payment formula. However, given the reality of our country’s fiscal climate and the difficulty that this Congress has had in agreeing to the most non-controversial items, a two year update may be the best case scenario. The AGA continues to meet with members on both sides of the aisle to discuss ideas for transitioning physicians to a new reimbursement system, and has learned that both Democrats and Republicans prefer to move physicians away from fee-for-service and into more value-based care. 

This process remains very unpredictable as Congress wants to finish their year-end business by Dec. 19 or 20. The AGA will continue to advocate for a fair and equitable reimbursement system that ensures patients have access to specialty care.

Look for updates on the AGA Washington Insider and AGA eDigest.

* Picture courtesy of the Architect of the Capitol.

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