Anesthesia Billing and Collections: House and Senate Conferees Begin 'Doc Fix' Discussions
Author : Doc Clemens
House and Senate Conferees Begin 'Doc Fix' Discussions
House and Senate negotiators have begun meeting to address the Medicare “doc fix”. Under a statute enacted in December, a scheduled 27 percent Medicare pay cut for physicians was deferred until the end of February. The statute also extended a number of provisions for hospitals, nursing homes and ambulance service providers. Several members of the conference committee are seeking a long-term solution to the Medicare sustainable growth rate issue. For example, Rep. Dave Camp (R-MI) said the fix should be for one to two years or longer, while Rep. Chris Van Hollen (D-MD) said the fix should go “at an absolute minimum to the end of the year.” Rep. Allyson Schwartz (D-PA) said that using short term fixes only adds to the cost of a permanent replacement of the Medicare sustainable growth rate. “In 2005, the cost of a full [sustainable growth rate] repeal was less than $50 billion. Today, the cost has grown to $300 billion. In five years, the cost of short-term fixes and accumulated SGR debt will reach approximately $600 billion.”
Many observers believe that hospital and home health agency reimbursement will be cut to pay for the “doc fix.” Former CBO Director Douglas Holtz-Eakin recently said that Medicare home health care reimbursement could be reduced by as much as $10 billion. Medicare payment reductions for hospital outpatient departments for evaluation and management services also are possible.
A large group of major industry stakeholders and medical societies representing nearly all 50 states have suggested that Congress use excess baseline projections for Overseas Contingency Operations (OCO) to help offset necessary Medicare baseline changes. The groups joined together in a letter to the conference committee asking the committee to consider using the funds originally allocated for the war as a means to pay for the SGR fix. They state in their letter that “[u]sing the OCO baseline as an offset for the accumulated SGR bad debt amounts to ‘cleaning the books,’ by eliminating one flawed budget gimmick with another and allowing for a more accurate accounting of future government expenditures without increasing the federal deficit. It also provides an opportunity to immediately repeal the SGR and to establish a pathway toward a truly sustainable physician payment system that focuses on improving quality and value for our nation’s Medicare beneficiaries.” The Federal of American Hospitals offers a different solution – adding medical malpractice tort reform to the solution, saying in their letter that this could generate in excess of $50 billion in savings.