The Doc Fix Reemerges In The Lame-Duck Session

With Congress back in session, will policymakers fix the Medicare reimbursement formula or just pass another extension? Now that the dust has settled from the midterm elections, Congress gaveled back into session for the first week of its lame-duck session before the Thanksgiving holiday. It could be a period of more bipartisan compromises as many policymakers will no longer have to be worrying about electoral politics and working with colleagues across the aisle is now an option. While there are big-ticket items like whether or not to extend the Bush tax cuts, another issue that keeps getting kicked down the road is how Congress intends to solve the ?doc fix? problem. What has become healthcare reform?s never-ending story, the doc fix represents the gap in the formula for Medicare physicians? reimbursement rates versus the current payment rate. Under current law, physicians accepting Medicare payments are scheduled to receive a 23.5 percent pay cut on Dec. 1 with an additional 1.5 percent decrease on Jan. 1, 2011. But, faced with the politically unfriendly decision of slashing the physician payments, our lawmakers have continuously passed last minute extensions during the past several years. As you might recall back in June 2010, Congress not only enacted a $6.5 billion extension, but also increased payments by 2.2 percent for six months through a series of hospital savings and pension changes. In just a few weeks, the extension expires. The end result is the looming gap is getting larger. Last week, Senate Finance Committee Chairman Max Baucus (D-MT) and Senator Chuck Grassley (R-IA) reached a temporary compromise to extend the 2.2 percent increase in reimbursements for another month. The legislation ? approved in a unanimous Senate vote ? comes with a $1 billion price tag, fully paid by cuts in payments for physical and occupational therapists, which primarily affects hospital payments. Under the agreement, therapy payments for more than one therapy on a certain day will be reduced, which extends the current doc fix formula until January. But, the game is not over. From the Senate, the bill now travels to the House, which is out of session until after the Thanksgiving holiday. Meanwhile, the American Medical Association, the Department of Health and Human Services, and the White House have come out with a different 13-month doc fix extension ? a proposal already supported by some House Democrats. The proposed new extension would allow Washington time to establish a permanent solution for consideration by the new Congress next year. However, with an estimated price tag of $15 billion, many lawmakers are going to be hesitant to support such a proposal in the current environment. The clear mandate of the electorate in the midterm elections was to cut spending and focus on the economy. Congress is between the proverbial rock and a hard place on this one. And, overriding all other concerns is the fact that the current reimbursement system needs to be moved in new directions or the Medicare system will be bankrupt in a few years. The ?doc fix? is like a soap opera that never ends. It?s clear we haven?t seen the last of this important issue for the healthcare community?mobile phone softwares cell phone softwares cell phone application cell phones