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Physician Anger Rises over Congress' Failure to Meet June 1 Doc Fix Deadline

Janice Simmons, for HealthLeaders Media, June 1, 2010

For physicians, the third time has not been the charm this year for those looking to finally get some relief from a 21% cut in Medicare and TRICARE physician reimbursements. While the House voted on Friday 245 171 to approve of a 19-month plan to stall the 21% reduction starting June 1, the Senate will not be able to act until it returns from its Memorial Day recess June 7.

With the "doc fix" approved by the House, 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. This is the third deadline missed by Congress this year; the others were March 1 and April 1. In previous years, Congress had voted to delay the cuts annually.

The delay by Congress has been accompanied by sharp words from physician organizations. Last week, the American Academy of Family Physicians had expressed support for a patch proposed earlier by the House that would have extended postponement of the sustainable growth rate (SGR) formula by three years, with an increase for primary care services included in 2012 2013. But Friday, the group changed its tone over what it sees as Congress' inability to make more permanent changes in the SGR.

"Family physicians are outraged that Congress has jeopardized the healthcare security of millions of elderly and disabled Americans who depend on Medicare and TRICARE," said AAFP President Lori Heim, MD, of Vass, NC, in a prepared statement.

Congress needed to "retroactively rescind this pay cut and replace the deeply flawed SGR formula with one that reflects actual practice costs that physicians experience," she said. "The political gamesmanship must end. A comprehensive and stable Medicare payment system must be put in place."

"The American College of Physicians is deeply disappointed by Congress' recurring failure to pass legislation to stop a devastating 21% cut in Medicare and TRICARE payments to physicians," said ACP President J. Fred Ralston, Jr., MD.

Ralston, an internist in Fayetteville, TN, said that "too many members of Congress from both political parties" have declined to "support legislation to move toward a better and more stable payment system, which could have served as the basis for permanent repeal of the unworkable SGR formula."

"[Congressional members have] withheld their support even though they knew that the result will be to further undermine physicians' and patients' faith in Medicare and TRICARE," he added. "They withheld their support, even though they knew it would introduce chaos into physician practices."

ACP said that during the Memorial Day recess, it was encouraging its members to call on their congressional representatives to tell them that failure to move to "a more stable system to replace the unworkable SGR simply is unacceptable."

"Physicians and patients must let their representatives and senators know that enough is enough. Congress is wreaking havoc on the Medicare program and physician practices across the country," said American Medical Association President J. James Rohack, MD, in his blog. He called for physicians to "Make your voice heard during the Memorial Day recess."

As when Congress missed the other two deadline this year, the Centers for Medicare and Medicaid Services told its contractors to hold claims for Medicare reimbursement for 10 business days "to avoid disruption in the delivery of healthcare services" to beneficiaries and payment of claims for physicians.


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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