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.

Speaker of the House John Boehner.
National Journal
Billy House
Add to Briefcase
See more stories about...
Billy House
March 26, 2014, 8:58 a.m.

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.

What We're Following See More »
ONLY BROAD PRINCIPLES
Mulvaney: Tax Reform Details Won’t Be Released This Week
5 minutes ago
THE LATEST

Despite President Trump's announcement that his tax reform proposal would be released this week, Office of Management and Budget Director Mick Mulvaney now says it will be ready in June. This week's announcement will be limited to "specific governing principles."

Source:
OFFSHORE OIL AND GAS
Trump To Sign Order Calling For Expanded Drilling
1 hours ago
THE DETAILS

Donald Trump is expected Monday to sign an executive order which will mark his administration's first action on offshore oil and gas drilling. The order is expected to call for a "review of the locations available for offshore oil and gas exploration and of certain regulations governing offshore oil and gas exploration."

Source:
DOMESTIC PRIORITIES
Pence Cuts Asia Trip Short For Big Week
1 hours ago
THE DETAILS

Vice President Mike Pence has cut his Asia trip short "to race back to Washington, where the Trump administration faces a critical week on tax reform and a funding plan to keep the government running, an aide said on Sunday." Pence will return to Washington on Tuesday morning instead of Wednesday. Trump has a busy week ahead, as he plans to roll out a tax reform on framework, sign a number of executive orders, and works to keep the government open past Friday.

Source:
24% GOOD ENOUGH FOR FIRST PLACE
Macron, Le Pen Lead French Elections
3 hours ago
THE LATEST

"Centrist Emmanuel Macron and far-right politician Marine Le Pen led the first round of voting in France’s presidential election, according to early projections, as voters redrew the political map, placing the European Union at the center of a new political divide. Projections by the Kantar-Sofres polling firm showed Mr. Macron on track to win the first round with about 24% of the vote, ahead of Ms. Le Pen with nearly 22%." The vote marks the end of the country's dominance by conservative and socialist parties. The top vote-getters head to a runoff on May 7.

Source:
MENDING FENCES?
Trump to Deliver Keynote for Holocaust Memorial Event
3 hours ago
THE DETAILS

President Trump will deliver the keynote address for at the National Holocaust Museum's National Day of Remembrance ceremony on Tuesday. He'll speak from the Capitol Rotunda. The move is likely an effort to try to mend fences with Jewish groups. In January, "the White House ignited controversy when it didn't mention Jews or anti-Semitism in a statement on International Holocaust Remembrance Day." And certain members of his inner circle are still suspected of harboring white supremacist or anti-Semitic views."

Source:
×
×

Welcome to National Journal!

You are currently accessing National Journal from IP access. Please login to access this feature. If you have any questions, please contact your Dedicated Advisor.

Login