Doctors Are Tired of Being ‘Fixed’ by Congress

Congress got close to replacing Medicare’s payment formula but fell back on yet another short-term patch.

MIAMI, FL - FEBRUARY 21: Dr. Martha Perez examines Maria Lebron in a room at the Community Health of South Florida, Doris Ison Health Center on February 21, 2013 in Miami, Florida. Florida Gov. Rick Scott reversed himself on February 20, and now is callling for an expansion of Medicaid to Florida residents under the federal Affordable Care Act. (Photo by Joe Raedle/Getty Images)
National Journal
Clara Ritger
See more stories about...
Clara Ritger
March 31, 2014, 8:21 a.m.

Doc­tors’ groups are not happy about Cap­it­ol Hill law­makers’ in­ab­il­ity to reach agree­ment on Medi­care pay­ments.

The Sen­ate voted 64-35 to pass an­oth­er short-term “doc fix” on Monday, delay­ing a 24 per­cent cut in Medi­care’s pay­ments to doc­tors. The one-year patch squeaked through the House last week in a voice vote that many mem­bers didn’t even know was hap­pen­ing.

And doc­tors’ lob­by­ing as­so­ci­ations aren’t happy about it. They had high hopes for a solu­tion that would per­man­ently re­place Medi­care’s pay­ment sys­tem.

“The phys­i­cian com­munity made some tough choices and com­prom­ises,” a rep­res­ent­at­ive at one phys­i­cians’ or­gan­iz­a­tion said. “And we didn’t really see the same ef­fort put for­ward on the pay-fors. Frankly, I think that there was a re­luct­ance on both sides of the aisle — on both sides of the Cap­it­ol — to make pro­vider cuts, re­luct­ance to make those choices pri­or to the elec­tion.”

Since 2003, Con­gress has passed 16 “doc fixes” to stop auto­mat­ic cuts put in place by the Sus­tain­able Growth Rate for­mula used to de­term­ine Medi­care phys­i­cians’ pay.

The Sen­ate’s vote is widely viewed among the doc­tor com­munity as the dis­ap­point­ing con­clu­sion of a long, bi­par­tis­an, bicam­er­al ef­fort to come to agree­ment on a long-term re­peal and re­place­ment of that for­mula. Law­makers and in­terest groups reached an agree­ment on the sub­stance of a new pay­ment for­mula, but they couldn’t agree on how to off­set the bill’s roughly $140 bil­lion price tag.

“Too many in Con­gress lacked the cour­age and where­with­al to per­man­ently fix Medi­care to im­prove care for pa­tients and provide great­er cer­tainty for phys­i­cian prac­tices,” Ar­d­is Dee Hov­en, pres­id­ent of the Amer­ic­an Med­ic­al As­so­ci­ation, said in an email. “Con­gres­sion­al lead­er­ship had to re­sort to trick­ery to pass an SGR patch that was op­posed by phys­i­cians.”

The AMA, along with more than 80 oth­er doc­tors’ groups, sent a let­ter to House lead­er­ship con­demning the short-term fix.

What a short-term patch means for the le­gis­la­tion that would per­man­ently re­peal and re­place the SGR for­mula is un­clear: Mem­bers of Con­gress could sit back down to the ne­go­ti­at­ing table in the fall, after the midterm elec­tions, when they are fa­cing no guil­lot­ine if they make un­pop­u­lar cuts to pay for the bill.

This story was up­dated at 7 p.m. East­ern to in­clude the Sen­ate vote count.

What We're Following See More »
“CLINTON MUST BECOME THE NEXT PRESIDENT”
Bernie Sanders Seeks to Unite the Party
7 hours ago
THE DETAILS

Instead of his usual stump speech, Bernie Sanders tonight threw his support behind Hillary Clinton, providing a clear contrast between Clinton and GOP nominee Donald Trump on the many issues he used to discuss in his campaign stump speeches. Sanders spoke glowingly about the presumptive Democratic nominee, lauding her work as first lady and as a strong advocate for women and the poor. “We need leadership in this country which will improve the lives of working families, the children, the elderly, the sick and the poor,” he said. “Hillary Clinton will make a great president, and I am proud to stand with her tonight."

“MUST NEVER BE PRESIDENT”
Elizabeth Warren Goes After Donald Trump
8 hours ago
THE DETAILS

In a stark contrast from Michelle Obama's uplifting speech, Massachusetts Senator Elizabeth Warren spoke about the rigged system plaguing Americans before launching into a full-throated rebuke of GOP nominee Donald Trump. Trump is "a man who has never sacrificed anything for anyone," she claimed, before saying he "must never be president of the United States." She called him divisive and selfish, and said the American people won't accept his "hate-filled America." In addition to Trump, Warren went after the Republican Party as a whole. "To Republicans in Congress who said no, this November the American people are coming for you," she said.

FLOTUS OFFERS STRONG ENDORSEMENT OF CLINTON
Michelle Obama: “I Trust” Hillary Clinton
8 hours ago
THE DETAILS

"In this election, and every election, it's about who will have the power to shape our children for the next four or eight years of their lives," Michelle Obama said. "There is only one person who I trust with that responsibility … and that is our friend Hillary Clinton." In a personal and emotional speech, Michelle Obama spoke about the effect that angry oppositional rhetoric had on her children and how she chose to raise them. "When they go low, we go high," Obama said she told her children about dealing with bullies. Obama stayed mostly positive, but still offered a firm rebuke of Donald Trump, despite never once uttering his name. "The issues a president faces cannot be boiled down to 140 characters," she said.

SANDERS BACKER CONFRONTS STUBBORN SANDERS SUPPORTERS
Sarah Silverman to Bernie or Bust: “You’re Being Ridiculous”
9 hours ago
THE DETAILS

Many Bernie Sanders delegates have spent much of the first day of the Democratic National Convention resisting unity, booing at mentions of Hillary Clinton and often chanting "Bernie! Bernie!" Well, one of the most outspoken Bernie Sanders supporters just told them to take a seat. "To the Bernie-or-bust people: You're being ridiculous," said comedian Sarah Silverman in a brief appearance at the Convention, minutes after saying that she would proudly support Hillary Clinton for president.

‘INEXCUSABLE REMARKS’
DNC Formally Apologizes to Bernie Sanders
13 hours ago
THE LATEST

The Democratic National Committee issued a formal apology to Bernie Sanders today, after leaked emails showed staffers trying to sabotage his presidential bid. "On behalf of everyone at the DNC, we want to offer a deep and sincere apology to Senator Sanders, his supporters, and the entire Democratic Party for the inexcusable remarks made over email," DNC officials said in the statement. "These comments do not reflect the values of the DNC or our steadfast commitment to neutrality during the nominating process. The DNC does not—and will not—tolerate disrespectful language exhibited toward our candidates."

Source:
×