House Energy and Commerce Committee takes on Medicare payment reform issues

May 7 2011

During a Thursday hearing, medical societies weighed in on efforts to fix Medicare reimbursement and Committee Chairman Fred Upton, R-Mich., said a repeal of the current physician payment formula is on the "short list" of things to get done this summer.

The Wall Street Journal Health Blog: Medical Societies Weigh In On Permanent Fix To Medicare Reimbursement
At a House subcommittee meeting today, medical societies weighed in on how to fix the much-maligned Medicare physician payment formula. The current formula, which absolutely no one thinks can continue in its present form, is (ironically) called the Sustainable Growth Rate, or SGR. It pegs the growth of Medicare reimbursement to the GDP — problematic, since GDP growth has famously been outpaced by the increase in health-care spending for years. Automatic, across-the-board reimbursement cuts kick in if spending reaches a certain level (Hobson, 5/5).

The Fiscal Times: Medicare 'Doc Fix' Put On Life Support By AMA Lobby
The annual scramble to prevent next year's scheduled pay cut for doctors who treat Medicare patients kicked off Thursday with physician leaders calling for a five-year program of guaranteed annual raises and a high-ranking House Republican calling for another short-term fix. The issue - known inside the Beltway as "the doc fix" - is the residue of a law enacted by Congress in the late 1990s that sought to limit the growth of Medicare spending on seniors' health care (Goozner, 5/6).

Politico Pro: E&C To Explore Options On 'Doc Fix' Menu
Energy and Commerce Committee Chairman Fred Upton pledged during a hearing on physician payment reforms Thursday that repealing the current Medicare payment formula is "on the short list of getting things done this summer." For now, committee members are exploring a menu of options that include bundled payments, episode groupers, balance billing and a capitated payment model in place in Massachusetts (Coughlin, 5/5).