Democrats Propose Long-Term Fix to Medicare Cuts
An extended punt to the can we call "SGR-defined cuts in Medicare reimbursement" is now proposed by Congressional Democrats Max Baucus of the Senate and Sandy Levin of the House. The punt, or delay, in Medicare reimbursement cuts is defined in the new bill, "American Jobs and Closing Tax Loopholes Act," a summary of which is provided at Levin's website.
In the section, "Maintaining Access to Affordable Health Care," the bill provides "reasonable updates in physician payment rates" for the rest of the year and 2011. In 2012 and 2013, the rates could actually increase "if spending growth on physician services is within reasonable limits," particularly in the contexts of primary and preventive care. The provision further stipulates that Medicare reimbursement rates would "return to their current law levels" after 2013. According to Medscape's coverage, that means Medicare reimbursement could fall by more than 30% in 2014.
Of course, God or the devil is in the details. The text of the bill was reportedly released yesterday as the House Amendment to the Senate Amendment to HR 4213, aka the "American Workers, State, and Business Relief Act of 2010." However, my web search is coming up empty.
The current stop-gap measure to delay the 21% SGR-defined cut in Medicare reimbursement is scheduled to expire in 11 days (June 1st). Some Republicans (eg, Jim Bunning) have balked at passage of these stop-gap bills, arguing that they add substantially to the federal deficit.
For background reading on this subject, here are previous posts in reverse chronological order:
On Medicare Cut: Congress Once Again Gives Itself Little Time to Grow a Pair
On Medicare Cut, Senate Kicks the Can Again
Bunning Still Blocking Extension of Medicare Reimbursement
Senator Bunning: Persona Non Grata Among Practicing Physicians
SGR = sustainable growth rate.
Photo of weathered can from magannie at Flickr.
05/22/10 addendum: More on this story from Rob Lowes at Medscape (who's doing a superior job, BTW, of covering this issue.) According to Lowes, professional groups like the American Academy of Family Physicians (AAFP) and the American College of Physicians (ACP) give qualified thanks to Baucus and Levin for the proposed freeze and the potential raise in Medicare reimbursement rates. But both groups, along with the AMA, urge Congress to step up and repeal the mandated use of the SGR formula to define Medicare reimbursement—which the latest amendment doesn't do. Instead, in 2014, the proposed legislation portends a precipitous drop of more than 30% in Medicare reimbursement rates.
Repeal of the SGR formula, however, is a nearly impossible fight. According to Lowes, who cites the CBO, freezing Medicare reimbursement rates through 2020 would cost the government $276 billion. SGR-repealing bills proposed by the House and Senate last year had price tags of more than $200 billion. They died because of lack of bipartisan support.
The full text of the Baucus-Levin amendment is now available here.
