Senate Delays Doc Pay Cut for 30 Days

The Senate overwhelmingly voted Tuesday night to delay for 30 days a 21.2% pay cut in Medicare reimbursement for physicians. The tally came after Sen. Jim Bunning, R-KY, agreed to a vote after blocking the measure since last week.

By agreeing to the physician pay cut delay, the Senate finally joined the House, which approved its 30-day delay legislation last week. By a 78-19 vote, the Senate approved the measure.

Bunning repeatedly blocked the $10 billion measure since last Thursday, saying it was too costly, referring not only to the physician issue, but also to other programs, such as Medicare, COBRA, and unemployment and highway projects.

While Bunning put a stranglehold on the measure, physician organization grew increasingly angry with the Senate, saying its inability to pass legislation was detrimental to patients, particularly senior citizens.

Before voting, Democrats and Republicans spent hours on Tuesday bickering over the wide-ranging ranging legislation. Around 9 p.m. last night, however, Democratic leadership and Bunning reached an agreement. Bunning was given the opportunity to offer a tax loophole amendment on paper products, which was defeated.

"We have a clear cut example of what's wrong with Washington, DC," said Sen. Patty Murray, D-WA, on the floor. "One single Republican senator is forcing doctors to take a 21 % cut" that could have an impact on senior citizens, Murray said.

Through much of the day, Bunning said he was steadfast in voting against the legislation, adding that the country was "going to implode in [a] massive amount of debt."

At one point on Tuesday, Bunning indicated that he had support of physicians in Kentucky, despite the physician pay cut issue. "As far as docs are concerned, I have a history with ‘doc fix," Bunning told his colleagues, referring to the nickname of the legislation to stave off the physician pay cuts. "I don't need to defend myself to the majority leader, just check with the Kentucky Medical Association."

Without Senate action, the physician pay cut technically took effective on March 1, but the Centers for Medicare and Medicaid Services postponed the action by instructing contractors to hold claims for at least 10 days. The CMS indicated that it expected a congressional response would prevent the cuts.

Sen. Max Baucus, D-MT, said that it was important that "we're finally going to see doctors get paid."

The physician pay cut issue has been dependent continually on congressional action, much to the consternation of physicians. On Dec. 19, Congress voted to delay the scheduled payment cut until March 1.

Specifically, the Medicare payments were scheduled to be cut across the board in accordance with the sustainable growth rate (SGR) formula.

The proposed delay ostensibly is to give Congress time to adjust the SGR formula. SGR links Part B Medicare reimbursement to the gross domestic product. The formula has led to proposed large cuts annually, which physicians have successfully worked to delay.