Medicare payment expiration looming, lawmakers look to 'doc fix'

Lawmakers are considering the 17th short-term patch for the problematic Medicare sustainable growth, as a deal for a permanent fix seems unlikely before the March 31 deadline.
By Gabrielle Levy  |  March 24, 2014 at 2:37 PM
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WASHINGTON, March 24 (UPI) -- With a deadline just a week away before Medicare payment rates fall by a quarter, lawmakers have moved to consider yet another patch fix.

Provider groups were hopeful that this time, Congress would be able to come to a bipartisan agreement that would permanently get rid of the current payment formula, known as the sustainable growth rate.

Instead, disagreements over how to offset the program's costs have prevented lawmakers from coming to a deal, which makes it likely a short-term patch -- known as a "doc fix" -- will be passed for the 17th time in 11 years.

If Congress fails to pass either a replacement for the SGR or a short-term fix by March 31, payment rates to medicare providers will be cut 24 percent. Providers say they are wary another patch will kill momentum for a long-term solution, but prefer that to slashed payments.

“We’re very hopeful that another patch doesn’t mean that further work on a bipartisan bicameral solution won’t happen,” said Reid Blackwelder, president of the American Academy of Family Physicians.

The effort to pass a permanent fix has been spearheaded by Sen. Ron Wyden, D-Ore., which will cost $180.2 billion, according to the Congressional Budget Office, and does not yet have an offset. The House version of the bill has attached a five-year delay for the individual mandate in the Affordable Care Act, which the Senate leadership says it will oppose and the White House has threatened to veto.

[CQ (Subscription)]

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