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Just before convening for the year, Congress passes bill to halt payment cuts
If signed, the legislation would give physicians a 0.5% increase through the end of June.
In a down-to-the-wire move, Congress passed a bill which will temporarily suspend the 10.1% physician payment cut scheduled for 2008 and implement a 0.5% payment update for 6 months of the new year.
In a 411-3 vote, Congress agreed to the Medicare, Medicaid and SCHIP Extension Act of 2007 (S. 2499) on Dec. 19. The bill temporarily spares physicians from a -10.1% payment update stipulated by the sustainable growth rate formula, which was slated to begin on Jan. 1. Instead, the bill would give physicians a 0.5% payment increase through June 30.
However, the bill has led to some confusion over what will happen if Congress fails to intervene again by July 1, with some physicians speculating that physicians could face an even larger cut down the road.
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As of press time, the president had yet to sign the bill.
Rollover said
“[What] happens to the 10.1% rollover?” Brian S. Parsley, MD, chairman of the American Association of Hip and Knee Surgeons’ Health Policy Committee and an alternate adviser to the American Medical Association’s Relative Values Update Committee said. “If it is delayed like it was last year ... we are potentially looking at a 15% cut this next year. And if they don’t address that, then that will be a different problem all together.”
The legislation, which was co-sponsored by Senators Chuck Grassley (R-Iowa) and Max Baucus (D-Mont.) was unanimously passed by the Senate on Dec. 18. If endorsed by the president, the bill would also extend the State Children’s Health Insurance Program (SCHIP) and continue physician payment incentives under the Physician Quality Reporting Initiative (PQRI). The Congressional Budget Office anticipates the bill to cost nearly $6 billion.
Delaying a decision
“This bill includes essential policies for the government to make sure doctors can continue to treat Medicare beneficiaries and to preserve health care services in rural areas of the country,” Grassley stated in a press release. “It’s a 6-month extension that serves as a stopgap until Congress can take care of the important Medicare business that got backed up this fall.”
Orthopedics TodayBusiness of Orthopedics section editor Jack M. Bert, MD, said that physicians are grateful for the bill, but said that it postpones a long-term fix. He also noted that physician costs only encompass a small portion of the total Medicare costs.
“Thankfully, the 10% Medicare cut has been delayed for physician reimbursement,” Bert told Orthopedics Today. “The 0.5% increase doesn’t even come close to compensating orthopedists for our cost of living or practice expenses that are increasing on a daily basis, but it is certainly an improvement over what they had originally intended to do.”
Choosing to stay
Orthopedics Today’s Chief Medical Editor Douglas W. Jackson, MD, said that he will stay in the Medicare plan for the next 6 months, but the future beyond that doesn’t look bright.
“The [10.1%] cut they proposed had reached beyond the bottom line I am willing to accept,” he told Orthopedics Today.
He was not surprised by Congress’ action. “It is not well thought out or approached with long-term reform,” he said. “The current Medicare program’s viability is based on price controls, decreasing reimbursements and raising taxes. This is going to come up again.”
American Medical Association board chair Edward Langston, MD, claimed in a press release, “We strongly urge Congress to break the tradition of short-term interventions that are not funded and fail to chart a course for replacing a flawed payment formula that is a barrier to improving quality and access to care for seniors.”
The December motion marks yet another step by Congress to counteract cuts called for by the statutory formula, which has calculated a negative update for physicians since 2002. Last March, Congress retroactively suspended a -5% update scheduled for that year, which culminated in a 10.1% cut scheduled for 2008.
For more information:
- Jack M. Bert, MD, can be reached at 17 W. Exchange St., 307 Gallery Medical Building, St. Paul, MN 55102; 651-223-9204; e-mail: bertx001@tc.umn.edu.
- Brian S. Parsley, MD, is an orthopedist at Baylor College of Medicine, 6620 Main St., 13th Floor, Houston, TX 77030, 713-986-6016; e-mail:bparsley@bcm.edu.
- Douglas W. Jackson, MD, can be reached at Memorial Orthopedic Surgical Group, 2760 Atlantic Ave., Long Beach, CA 90806-2755; 562-424-6666; e-mail: jacksondw@aol.com.
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