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Congress Passes 10-Month SGR Fix

MedPageToday, 2012

The House of Representative voted 293-132 Friday morning to pass the bill, and the Senate passed it by a 60-36 vote less than an hour later.
The compromise -- which also provides a year-long payroll tax cut extension and an extension of unemployment benefits -- would hold Medicare payment rates to doctors steady at 2011 rates through this year.
Without legislative action, a 27.4% reduction in Medicare payments was scheduled to kick in on March 1.
The price tag on the "doc fix" is close to $18 billion and will be paid for by cutting other areas of the budget, including certain provisions in the Affordable Care Act (ACA).
That includes taking $5 billion from a $15 billion fund designed to pay for programs to prevent chronic disease over the next decade.
The compromise bill also cuts more than $4 billion in Medicaid disproportionate share hospital (DSH) payments, which are meant to compensate teaching hospitals for treating many of the sickest patients in the medical system.
The rest of the money to pay for the SGR fix would come from cutting payments to clinical laboratories and from reducing the amount Medicare pays hospitals for bad debt.
The bill also extends current payment rates for a number of programs, including ambulance services, but extra payments for bone density scans and for certain mental health services will be eliminated.
Doctor's groups were relieved the 27% cut wouldn't go into effect, but called the bill a missed opportunity to permanently repeal the SGR.
Last month, the AMA and 109 other medical groups suggested using savings from cost projections for the war in Iraq to fund the SGR fix.