Source: MedPage Today
The Senate voted late Tuesday to stave off Medicare cuts to physicians until the end of March, finally overcoming a one-man blockade by Sen. Jim Bunning (R-Ky.).
By a 78-19 vote, the Senate passed the $10 billion bill, which extends a number of programs, including federal programs for unemployment assistance, COBRA assistance, flood insurance, and highway funding.
In particular, it offers physicians a temporary reprieve from 21% cuts to reimbursement under Medicare. The cuts will now go into effect March 28 unless Congress passes a longer-term fix.
After Congress failed to pass a bill last week to stave off the cuts mandated under the sustainable growth rate (SGR) formula, the reductions technically went into effect on March 1.
But the Centers for Medicare and Medicaid Services (CMS) effectively postponed them by instructing contractors to hold claims until March 12, betting on Congressional action to stop the cuts before then.
Bunning, a former pitcher for the Philadelphia Phillies and Detroit Tigers who is retiring from the Senate this year, repeatedly objected to passing the bill through a procedure called unanimous consent.
Bunning said he couldn't support a bill that is not paid for, but relented on Tuesday night when he was allowed to introduce an amendment on the floor that would have paid for the $10 billion bill by closing a tax loophole for the paper industry.
His amendment was rejected, but he will be permitted to bring another amendment to the floor later this week when the Senate is expected to vote on a much larger package, introduced Monday by Senate Majority Leader Harry Reid and Sen. Max Baucus.
That bill would cost $150 billion and extend the delay in doctor payment cuts for seven months.
The scheduled cuts are mandated under the sustainable growth rate (SGR) formula -- the Medicare accounting scheme that links Part B reimbursement rates to the gross domestic product (GDP).
Because the GDP has grown more slowly than the growth in health care spending, the formula would have required the government to cut reimbursement rates over most of the last decade.
So organized medicine has rallied its lobbyists to successfully fight the cuts every year.
But the long battle has left doctors weary of this annual ritual, and this year they have been vocal in opposing a temporary fix. As a result, organized medicine is now pushing hard for a permanent solution that would scrap SGR altogether in favor of a formula less onerous to them.