Budget bill’s passage means fee fix is possible

WASHINGTON — The budget bill passed last week by the House and Senate may derail the expected 4.4% reduction in Medicare physicians’ fees. The fee cut had been expected to take effect March 1.

The FY 2003 Omnibus Spending Bill includes language that allows errors in the sustainable growth rate (SGR) to be fixed by the Centers for Medicaid and Medicare Services (CMS).

Physician’s groups, including the American Academy of Ophthalmology, have argued that CMS has the legal authority to fix the SGR, but CMS has maintained that it does not have that authority. The language in the new budget bill now removes this barrier.

An AAO news release states that the administration will act by March 1 to give physicians an increase, instead of the 4.4% cut that has been expected.

“This is actually a 10-year fix,” said Steve Miller, the director of the AAO’s OphthPAC and political affairs. “We know it halts the 4.4% cut, and [the bill] leads to a 1.6% increase, assuming CMS makes the change. The question is, What does [the bill] do for the formula from here on out? It doesn’t correct all of the problems with the formula. It only corrects two of the major flaws.”

The budget bill was approved by Congress on Feb. 14, 2003, with a total spending package estimated at $378 million.

Mr. Miller said his group plans to take a 2-week hiatus to assess how the SGR formula might actually change in light of the new wording and how, or if, the Medicare Payment Advisory Commission’s recommended 2.5% increase for 2004 may also change in light of the new bill.