Senate Leaves for Weekend Without Taking up Doc Pay Cut

The House overwhelmingly approved a measure Thursday night to postpone a proposed 21.2% pay cut to physicians, which was scheduled to go into effect on Monday, for at least 30 days.

The action—at least temporarily—is a reaction to physicians who have been upset over the failure of Congress to permanently deal with the payment issue. Physicians say the pay cut would force large numbers of doctors to stop seeing Medicare patients.

The House vote on the Medicare Physician Payment Reform Act was 315-to-97, with 87 Democrats and 10 Republicans opposing the measure. There were 20 abstentions.

Despite the House action, the physician pay cut will go into effect Monday, unless the Senate acts, according to Joe Stubbs, president of the American College of Physicians.

"It doesn't seem like the Senate will act in time, maybe Tuesday," he says. "This is very disturbing to physicians. It's just an ongoing battle to deal with this inequitable problem."

The American Medical Association criticized the Senate for not voting on the pay cut delay before leaving for the weekend. The Senate "left early for the weekend, abandoning seniors military families and baby boomers," said the AMA.

By failing to repeal the Medicare physician payment formula, a "Medicare meltdown now seems certain," the AMA stated in a release.

The pay cut will force physicians to consider whether to limit the number of Medicare and TRICARE patients they see in order to keep their practice doors open, said the AMA.

"Our message to the U.S. Senate is stop playing games with Medicare patients and the physicians who care for them," said AMA President J. James Rohack, MD. "It is shocking that the Senate would abandon our most vulnerable patients, making them the collateral damage of their procedural games."

One in four Medicare patients seeking a primary care physician is having trouble finding one, according to MedPAC, Congress' advisory body on Medicare. Physicians have told AMA that steep Medicare cuts will force them to limit the number of Medicare patients they treat.

A new 2010 survey of neurosurgeons found that 60 percent are already reducing the number of Medicare patients in their practices, and cuts will force nearly 40% to decrease the number of new Medicare patients they see, according to the AMA. More than 18% of neurosurgeons will no longer take new Medicare patients.

There could be a temporary solution to the issue this weekend. Stubbs says there is a possibility that the Centers for Medicare and Medicaid Services may be able to delay federal payments act for several days, or at least until the Senate takes action.

"Maybe CMS can delay the process and the Senate a little more time," Stubbs says.

CMS officials could not be reached for comment Friday.

While Congress has focused on healthcare reform, it has been relatively inactive on the pay cut issue, as the deadline approaches. The inaction has prompted sharp rebukes from organizations representing physicians.

The American Academy of Physicians said in a statement that it was "deeply angered at congressional failure to avert the mandated 21.2 % Medicare physician pay cut. This inaction—in the face of virtually universal calls by the medical community and advocates for Medicare beneficiaries—has put elderly and disabled patients at risk of losing access to care and imposed potentially devastating fiscal hardship on physicians."