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'Doc Fix' is Unfixable

Joe Cantlupe, for HealthLeaders Media, December 8, 2011

Anders Gilberg, a senior VP at the Medical Group Management Association, heard National Public Radio commentators discussing the "doc fix" on his commute to Washington, D.C., the other day.

Gilberg felt good that panelists and politicians were even talking about the issue. That's because in the nation's capital, if it's being discussed, there's a possibility that something may actually happen on Capitol Hill, he says.

Gilberg and other observers believe there is a good chance that Congress will take up the doc fix before the January 1 deadline. If the House and Senate don't act by then, it means a 27.4% cut to Medicare providers on the first day of 2012. The pain would be palpable.

Holiday adjournments may get in the way, although Democratic leaders in the U.S. House of Representatives have called on their Republican counterparts to act before December 16.

Despite politicians' talk about a doc fix, though, the problem never really gets fixed—just put off for another time.

Last year, the doc fix was continually on the ledge. Congress stalled six times and imposed "patches" on the Medicare Sustainable Growth Rate payment formula to stave off cuts that would have amounted to 20%. Since 2003, Congress has taken steps each year to override the cuts required by the formula.

 "The scheduled cuts have increased from 5% in 2002 to the current level of 27%," Peter W. Carmel, MD, president of the AMA, writes in a recent blog.

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