Congress weighs bill to stop Medicare 4.4% pay cut

A bill introduced by Rep. Bill Thomas (R, Calif.) on the first day of the 108th Congress would halt implementation of the physician fee schedule rule — including the pay reduction — released by the Bush administration in late December.

“One of the biggest problems is that physicians face significant and successive payment cuts that could harm patients’ access to care,” Thomas said. “Our newest legislation would block the 4.4% cut from taking effect.”

The measure would rely on an infrequently used mechanism that allows Congress to overturn regulations issued by federal agencies within 60 days of publication. The Congressional Review Act limits debate in the Senate to 10 hours and bans filibusters.

The House approved a bill last year that would have replaced the 2003 cut with a 1.9% increase. The Senate, however, was unable to pass the measure as key lawmakers, including Sen. Charles Grassley (R, Iowa), balked at offering a bailout for physicians without including funds for other health care groups.

Grassley, who is now chair of the Senate Finance Committee, has objected to the Thomas bill this year because it would set aside other provisions contained within the physician fee schedule rule. Grassley is trying to broker an alternative approach in the Senate that would maintain physician payments at 2002 levels and provide some limited relief for rural hospitals.

This demonstrates the problem with our political system. Take an issue with general agreement and Senators will always try to attach another provision. I agree with finding relief for rural hospitals. But that is a different issue and should be a different bill.

“Physicians have already taken a 5.4% cut in 2002,” Dr. Coble said. “If Congress doesn’t act by March 1, physicians will take cumulative payment cuts of 10% for treating our nation’s seniors and disabled, with more cuts to come.”

Dr. Coble said there was widespread agreement in Washington that the cuts resulted from a mistake in calculations and should have been fixed long ago.

Many physician practices already have decided to limit the number of new Medicare patients they will take, while others are contemplating a change to nonparticipating status this year. That would allow them to make up for the shortfall in government payments by billing their Medicare patients more.

And advocates cannot understand why physicians fear universal health plans. They would have to orginate with Congress. And we do not trust them to [1] pass the right bills or [2] correct their mistakes. Maybe we should just sue them for malpractice!

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2. Congress takes a vacation
3. Supporting health reform
4. Ineptitude in Congress
5. Some thoughts on health care reform

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