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Doc Fix Delay Shortened in Amended House Bill

Janice Simmons, for HealthLeaders Media, May 27, 2010

The House appears close to voting today on the "American Jobs and Closing Tax Loopholes Act of 2010" (HR 4213) that contains a provision to delay a 21% cut in physician Medicare reimbursements—just before the latest deadline expires June 1. However, the actual period proposed for the delay has been whittled down to 19 months—or the end of 2011.

In earlier deliberations in the House this month, a five-year period was discussed, and then a 3½ year period—ending by 2014—was incorporated into the proposed bill late last week. However, legislators concerned about costs ($63 billion over 10 years) associated with a postponement in the sustained growth rate (SGR) formula pointed to a shorter period, which kept the jobs bill costs down.

Under the amendments approved late yesterday by the House Rules Committee, physicians would see an increase in payment rates of 2.2% for the remainder of 2010 and a 1% increase in 2011. Rates would return to present law after 2011. No additional payments would be made for primary or preventive care (as proposed in the earlier bill). Costs are now estimated at $22.9 billion over 10 years.

Other changes in the bill from last week include a program to provide a 65% COBRA health insurance premium subsidy for up to 14 months now through November 2010 (instead of December 2010) for employees who were terminated from their job.

If the bill passes the House, it will immediately move on to the Senate. Senate Finance Committee Chairman Max Baucus (D-MT) said Wednesday that Senate Democrats are expected to have the votes to approve the measure.

The amendment changes came after the American Academy of Family Physicians, the American College of Physicians, the American Osteopathic Association, and AARP had urged Congress in a news conference on Wednesday to keep to its plans for a 3½ year postponement of the SGR.

AAFP President Lori Heim, MD, of Vass, NC, said failure to stop the pay cut after the June 1 deadline could reduce the quality of services—as some physicians will try to shorten office visits to see more patients or be forced to lay off staff.


Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.

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