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Senate committee weighs plan to further stall Medicare payment cut
Chairman aims to offer bonuses for primary care physicians without reducing payments for surgeons.
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Legislation under consideration in the U.S. Senate would delay a proposed 10% Medicare physician payment cut by 18 months.
Senate Finance Chairman Max Baucus, D-Mont., said he hoped to introduce the Medicare legislation to the full Senate in early June, according to his staff.
The legislation would block a planned reduction in the sustainable growth rate (SGR), a formula to annually update Medicare physician payments, according to a news release issued by Sen. Baucus’ office.
AAO response
 Catherine Cohen |
Catherine Cohen, AAO vice president for governmental affairs, lauded efforts by Sen. Baucus and ranking committee member Charles Grassley, R-Iowa, to stall the physician payment cut and implement a positive update.
“His response to our call for an immediate and positive update for an extended period of time that would allow all parties to collaborate on a long-term solution is gratifying,” Ms. Cohen said in a telephone interview with Ocular Surgery News. “It is evidence that he is hearing us.”
Sen. Baucus aims to extend a 0.5% positive payment update to Dec. 30 and implement a 1.1% update for fiscal year 2009, as recommended by the Medicare Payment Advisory Commission (MedPAC), Ms. Cohen said. The current positive update is due to expire June 30.
“This is a very ambitious goal by the senator,” she said. “We only got a 3- to 6-month fix the last time Congress acted. We’re very concerned that people won’t rally around the chairman’s proposal, we end up with another 6-month fix and they have to come back after the election in November or December. The worst case is that they would have to intervene twice, once to stop the July 1 cut and then after the election to stop the Jan. 1 cut. We believe that’s a very poor outcome.”
The AAO, other physician groups and lawmakers need to explore possible alternatives to the SGR, which does not keep pace with the rising cost of practicing medicine, Ms. Cohen said.
“Even in the physician community, we are not unified,” she said. “We would like repeal, but if we can’t get repeal, we’re not unified on what would replace the SGR if some alternative had to be imposed. We need some time to come to consensus on that.”
In December, both houses of Congress passed legislation that stalled the payment cut until June 30. A similar measure halted a payment cut in December 2006.
Primary care vs. specialists
The Senate bill may also address bonuses for primary care physicians, Ms. Cohen said. The bonuses and other initiatives are intended to address an impending shortage of primary care physicians, she said.
MedPAC is recommending to Congress that increased payments for primary care physicians be “budget neutral,” requiring no additional funding of the Medicare system, according to an AAO statement. The AAO and other physician groups aim to ensure that specialists and surgeons are not forced to bear payment cuts to fund bonuses for primary care physicians, Ms. Cohen said.
“We need to make sure that the solution is not on the backs of specialists and surgeons who have had fees cut consecutively over the last 10 years,” she said.
Members of Sen. Baucus’ staff assured the AAO that bonus payments for primary care physicians would not be budget neutral, according to an AAO statement.
The bill may also include financial incentives for physicians to use electronic medical records and electronic prescribing and call for expansion of the Medicare Physician Quality Reporting Initiative, according to the AAO.
For more information:
- Catherine Cohen can be reached at American Academy of Ophthalmology, Governmental Affairs Division, 1101 Vermont Ave. NW, Suite 700, Washington, DC 20005; 202-737-6662; fax: 202-737-7061; e-mail: cgcohen@aaodc.org.
- Matt Hasson is an OSN Staff Writer who covers all aspects of ophthalmology. He focuses on regulatory, legislative and practice management topics.