The U.S. Senate today voted to postpone a 21 percent cut in Medicare payments to doctors & medical providers after lawmakers struck a last-minute deal as the reductions were to take effect.
The chamber, on a voice vote, agreed to delay the cuts until December after Democrats and Republicans agreed on savings elsewhere in the government’s budget to prevent the $6 billion measure from adding to the deficit.
The vote sends the measure to the House, which adjourned for the week. Senate Finance Committee Chairman Max Baucus, a Montana Democrat, said he expects lawmakers there to take up the legislation next week. The problem is that moments after the Senate acted, Medicare announced it would begin processing claims it has already received for June at the lower rate. The reason: the House cannot act on the fix until next week.
That means doctors, nurse practitioners, physical therapists and other providers who bill under Medicare’s physician fee schedule will have to resubmit their claims if they want to be made whole, with added paperwork costs both for the providers and for taxpayers.
“Congress is playing Russian roulette with seniors’ health care,” Dr. Cecil B. Wilson, president of the American Medical Association, said in a statement. “This is no way to run a major health coverage program.”
AARP, the seniors’ lobby, called the cut “unprecedented” and “dangerous” even if it’s only temporary. Nancy LeaMond, the group’s executive vice president, warned it would undermine confidence in the stability of the giant health care program for 46 million elderly and disabled people.
“This cut creates a dangerous atmosphere for seniors and their doctors, and will contribute to more doctors making the decision already made by some physicians to stop taking Medicare patients,” she said.
The billings affected by the cut cover the early part of this month. An earlier congressional reprieve expired May 31. Medicare had been holding off on processing claims in the hopes lawmakers would act, but the agency said it can no longer do that without hurting doctors’ cash flow.
The Medicare cuts are required under a 1990s budget-cutting law that Congress has routinely waived. This time, lawmakers’ concerns about adding to the deficit held up a deal to allow an exception to enforcement of the law.
The bill passed by the Senate delays the cuts until the end of November — after congressional elections — when lawmakers hope the political climate is better for passing a more permanent, and expensive, solution.
The bill would also increase payments to providers by 2.2 percent. The legislation, which costs about $6.5 billion, is paid for with a series of health care and pension changes that both Democrats and Republicans agreed to.
The Senate approved the measure by voice vote Friday after failing the night before to pass a larger package that included the funds.
The larger package included jobless benefits for the long-term unemployed, aid to cash-strapped states and the extension of dozens of popular tax breaks for businesses and individuals that expired at the end last year. The package failed to generate enough votes Thursday evening to end a Republican filibuster.
Vice President Joe Biden, speaking before the Senate acted, blamed Republicans for being unwilling go along with a permanent fix to the doctor cuts — which would cost tens of billions more. He said the underlying physician payment formula is unworkable, and should be repealed.
The political gridlock has angered doctors. The AMA says continuing financial uncertainty may lead some doctors to stop taking new Medicare patients, and others may drop out of the program altogether.
“It is astounding that Congress has let seniors down through their inability to deal with this problem on time and in a responsible fashion,” Wilson said.
The Senate acted separately on Medicare after a larger jobs bill including the provision was blocked yesterday because of its cost. Baucus called today’s agreement a “good omen” for the rest of the bill, saying, “I hope we can take this cooperation and work out the rest of the so-called extenders bill together.”
The Medicare cuts, mandated by a decade-old budget-control mechanism, were scheduled to take effect June 1. The Centers for Medicare and Medicaid Services delayed processing claims to give lawmakers time to work out an agreement. Those delays ended today.
Retroactive Increases
The agency said today it will begin processing the held claims at the lower rate, with the 21 percent cut, because the bill approved today hasn’t been signed into law. The measure would provide physicians with retroactive increases to make up for the cuts, along with a 2 percent payment boost through Nov. 30.
Lawmakers agreed to finance the plan by trimming hospital payments and tightening tax collections. The bill would also loosen pension funding requirements, which boosts tax revenue flowing into the Treasury because it results in companies making fewer tax-preferred contributions to their pension funds.
It is unfortunate that with all of this delay we still do not have a permanent fix to the problem. It makes you wonder what will happen next year and how much longer we will have to deal with the uncertainty of getting paid.
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