Senate Amendment Includes Temporary Doc Fix, Plus Medicaid Extension

Under the Senate substitute amendment to the jobs bill (HR 4213) unveiled Tuesday, physicians would get some relief from the 21% cut in Medicare and TRICARE physician reimbursements now in effect.

Using the same language found in the jobs bill passed by the House 10 days ago, 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.

At a "tele-town" meeting with seniors on Tuesday, President Obama did provide some recognition of the physicians' current plight by noting that "temporarily, we've got to make sure that your doctor is getting reimbursed so that they can stay in business and keep their doors open."

"We've got to fix this permanently," Obama said. "What we shouldn't do is have this guillotine hanging over their heads every year where they're having to figure out: 'Am I am going to get reimbursed or is suddenly my income going to drop by [21%]?'"

Making a reappearance in the jobs bill amendment was an extension of the Medicaid assistance plan—the Federal Medical Assistance Percentage (FMAP)—that was designed to help financially strapped states under the economic stimulus package pay for additional Medicaid coverage.

FMAP runs through Dec. 31 of this year, but many states had been calling for an extension through June 2011 to coincide with their state budget planning. The House had dropped the FMAP provision in its jobs bill approved last month over the price tag of the provision ($24.2 billion over 10 years) after pressure from fiscally conservative congressmen.

The Senate bill also keeps the provision, included in the bill approved by the House, to change Medicare's "72 Hour Rule" to prevent hospitals from submitting separate Medicare reimbursement claims for inpatient and outpatient therapeutic care that are provided within three days of a hospital admission. Hospital groups have expressed concern over the bill's payment reduction to hospitals.

Not included in the amendment—and excluded from the House jobs bill—were subsidies to assist unemployed workers in paying for their healthcare through COBRA through November of this year. The current subsidy expired this month.