AMA Urges House to Pass 'Doc Fix' Extension

The American Medical Association is praising the U.S. Senate's bipartisan vote Wednesday to delay by one year 25% Medicare reimbursement cuts to physicians, and is urging the House to follow suit before the Jan. 1 deadline.

"This one-year delay comes right as the oldest baby boomers reach age 65, adding urgency to the need for a long-term solution before this demographic tsunami swamps the Medicare program," said AMA President Cecil B. Wilson, MD.

The House has yet to take up the measure, and it's not clear how much support it will garner in the lame duck session.

"Stopping the cut for one year will inject some much needed stability into the system for seniors and physician practices who have spent this year in limbo because of five short-term delays," Wilson said. "We urge the House to quickly pass this critical legislation before the January 1 deadline when the 25% Medicare cut is set to begin."

Wilson said the AMA will work with Congress in the coming year to find a permanent solution to the so-called "doc fix." The Sustainable Growth Rate formula for Medicare funding dictates the cuts, but the cuts have repeatedly been delayed since Congress passed the measure a decade ago.

Delaying the cuts one more time would ensure that Medicare and Tricare, for active-duty service members, National Guard and Reserve members, retirees and their families, will pay physicians who participate in those programs at current levels.

The bill, the Medicare and Medicaid Extenders Act of 2010, also includes extensions of other expiring healthcare provisions, including protections for rural hospitals and doctors, Transitional Medical Assistance and the Special Diabetes Program.

Senate leaders patted each other on the back after approving the extension, which demonstrated a rare show of bipartisanship on Capitol Hill.

"This bipartisan agreement gives peace of mind to seniors and military families in Nevada and across the nation," said Senate Majority Leader Harry Reid (D-NV).  "We ensured that our seniors and veterans can continue seeing their doctors and getting the treatment they need."

Senate Minority Leader Mitch McConnell (R-KY) said he was "encouraged that we were able to work together in a bipartisan way and protect access to care for America's 45 million Medicare beneficiaries in a fiscally responsible manner."

Reid's office said the legislation would be paid for by modifying the policy regarding overpayments of the healthcare affordability tax credit.  This policy does not change the tax credits for which people are eligible based on their income.  Instead, the proposal would change the way people pay back overpayments when they have received more credit than they are eligible for because, for example, they earned more money than expected in a given year.   

Under current law there is a flat cap of $250 for individuals and $400 for families on the amount of the healthcare affordability tax credit people are required to pay back when they received an overpayment. This payback cap is the same for people earning 160% of the federal poverty level and 360% of the federal poverty level.  Under this proposal for correcting overpayments, the cap on the payback amount would be on a sliding scale based on the income of the recipient of the tax credit, making the policy fairer to both recipients and all taxpayers, Reid's office said.