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Boehner: We've Got a Doc Fix ... for Now Boehner: We've Got a Doc Fix ... for Now

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Boehner: We've Got a Doc Fix ... for Now

With a permanent agreement stalled, Congress has a one-year plan to prevent a cut in doctors’ payments.


(Win McNamee/Getty Images)

John Boehner says the House and Senate have cut a deal on another temporary patch to prevent a massive cut to doctors' Medicare payments.

The bill is expected to be taken up in an expedited process in the House on Thursday, as part of a noncontroversial suspension calendar.


Doctors face a 24 percent cut in their Medicare payments if Congress doesn't act by March 31. Medicare's payment formula calls for ever-increasing cuts, which Congress always delays. Doctors would rather have a new formula than another stopgap.

The House speaker told reporters Wednesday that House and Senate efforts have not concluded in trying to find a longer-term fix. He said there is bipartisan, bicameral agreement on the path forward, only not yet on "how we're ever going to pay for it."

The House passed a $137 billion permanent fix on March 14, which relied on savings tied to the repeal of the Affordable Care Act individual insurance mandate. But that was rejected by Democrats who lead the Senate, and it faced a presidential veto threat.


The temporary, smaller bill includes spending offsets from reductions in other Medicare spending; also, some of its costs are paid for by realigning sequester savings set to occur in 2025 to 2024.

aportion of its costs.Specifically, a portion of the bill's "savings" are achieved by simply shiftingsequester savings set to occur in 2025 into 2024, within the Congressional BudgetOffice's scoring window, but this has zero actual impact on the debt

Specifically, the Protecting Access to Medicare Act of 2014 would prevent the 24 percent cut in reimbursements to doctors who treat Medicare patients by replacing it on April 1 with adoption of a 0.5 percent update through Dec. 1. There would be no percentage changes for the three months following that through April 1, 2015.

Along with extending payments under what is formally known as the Medicare Sustainable Growth Rate formula through March of 2015, the bill also includes funding for various other expiring Medicare provisions.


Much of this is paid for though provider cuts and the Medicare sequestration savings time shift tied to the $2.3 billion set-aside for SGR in the budget deal worked out in 2013. It also delays scheduled reductions in payments to so-called disproportionate-share hospitals by one year.

Other Medicare-related programs that would be extended for a year include the geographic practice cost index, the ambulance add-on payments, and the Medicare Advantage Special Needs Program. It also adopts market-based private-sector payment rates for lab services.

The bill also extends through 2015 the Special Diabetes Program and Abstinence Education and delays for one year implementation the ICD-10 coding system for diseases and treatment procedures under the Medicare program. That classification system is intended to ensure that hospitals are documenting the correct treatment and payments for those treatments.


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Health Care Edge is one of my top resources."

Meghan, Associate Specialist

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