Doctors still waiting for Capitol Hill action on Medicare payment cuts

The Wall Street Journal: The Senate continues to weigh a bill with wide-ranging provisions, including a postponement of the scheduled Medicare pay cut for doctors, but Democratic leaders appear to be having difficulty finding a plan that will appeal to members. "Repeated short-term fixes in recent years have left doctors frustrated and some … are refusing to take new Medicare patients. Since the latest 'doc fix' expired May 31, doctors have been holding off on submitting claims until Congress approves another patch. On Saturday, President Barack Obama used his weekly radio address to urge Congress to fix the problem" (Adamy and Hitt, 6/16).

Kaiser Health News: "For physicians, this payment-cliff scenario is an increasing source of frustration. While lobbyists urge Congress to enact a permanent payment fix to provide stability to the system, doctors in individual practices regularly brace for the reimbursement roller coaster." The Senate is considering legislation to block the cut, and several doctors say action couldn't come soon enough. Their plans -- if the cuts do happen -- range from remaining steadfast in their commitment to see Medicare patients to becoming a "concierge" practice that doesn't deal with Medicare at all (Marcy, Villegas and Weaver, 6/15).

Also, Kaiser Health News' Mary Agnes Carey and the Los Angeles Times' Noam Levey discuss the doc fix on Health on the Hill (6/15).

But, giving doctors the 'fix' they want may simply cost too much for senators to swallow, The Washington Post reports. The House earlier passed a bill that would address the Medicare cuts as well as jobless benefits and aid to state governments, but "the political buzz saw of the Senate on Tuesday … began chopping apart" the legislation to reduce its deficit impact. While the House would postpone physician pay cuts until 2012, Sen. Majority Leader Harry Reid, D-Nev., "is considering protecting doctors only through the rest of this year" (Montgomery, 6/16).

The Associated Press: "Doctors are likely to win only a seven-month reprieve from a 21 percent cut in their Medicare payments that's set to take effect Friday." Even that scaled back plan may struggle to gain Senate support. "Nine Republicans supported the earlier version of the bill against a GOP filibuster, as did every Democrat but Ben Nelson of Nebraska. Now, a lot of that support has eroded." Sen. Susan Collins, R-Maine, said, "I'm very concerned about the cost of the bill" (Taylor, 6/16).

Meanwhile, "Senate Democrats and Republicans traded potshots Tuesday trying to one-up each other's support for the American Medical Association, as the battle over a $140 billion package of spending and tax breaks continued its slow crawl across the floor," CongressDaily reports. "Each day gets closer to a 21 percent cut for physicians who treat Medicare patients, and the length of a proposed 'doc fix' is likely to shrink, not grow, in deference to deficit concerns on both sides of the aisle. And no matter how long they postpone the pain, it will get worse -- the independent Medicare Payment Advisory Commission estimated Tuesday that physician payments could be cut by as much as 26 percent next year" (Cohn, 6/16).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.