KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Senate Reaches Deal, Passes Short-Term ‘Doc Fix’

The New York Times: The Senate Friday "approved a six-month plan to prevent a steep cut in doctors' fees paid" by Medicare. "The $6.4 billion measure would reverse a 21 percent cut in physician payments that was to kick in Friday ... The legislation, known on Capitol Hill as the doc fix, was approved without a roll-call vote after leaders of both parties agreed to pull it out of a stalled package of tax changes and safety-net spending. Senator Max Baucus, the Montana Democrat who leads the Senate Finance Committee, said the legislation was needed to avert 'near chaos in absence of medical care to seniors.'"

"The cost of the measure was offset by changes in Medicare billing regulations, antifraud provisions and the tightening of some pension rules, eliminating Republican objections that it would put the federal government deeper into debt. 'We've done it without adding to the deficit, and I think that is something both sides can feel good about,' said Senator Mitch McConnell of Kentucky, the Republican leader" (Hulse, 6/18)

The Hill: The bill "now moves to the House, where lawmakers are expected to take it up early next week. The House last month passed a 19-month fix, but the larger proposal drew pushback from Senate Republicans, who have fought to offset the new costs. (Mike Lillis and Vicki Needham, 6/18)

CongressDaily reports that the $6.5 billion price tag "is fully offset with two revenue-raising provisions. One would ban hospitals from charging Medicare for outpatient and inpatient services rendered within 72 hours of a hospital admission, estimated to save $4.2 billion. The other would raise $2.8 billion by allowing companies to spread out their pension fund obligations over a longer period" (McCarthy, 6/18).

"But leaders still have yet to resolve larger problems with restoring jobless benefits and middle-class tax cuts that expired earlier this month," Roll Call reports. Those provisions are included in the large jobs bill that stalled Thursday (Pierce, 6/18).

USA Today notes that Vice President Joseph Biden "blasted Senate Republicans" shortly before the Medicare compromise vote for blocking the fuller bill Thursday night. "Deviating from his script at an event designed to highlight government efforts to eliminate waste in spending, Biden called it 'a shameful example of business as usual' that could cause some doctors to stop accepting Medicare patients. Republicans are threatening seniors' access to doctors with 'this little game of brinksmanship,' Biden said" (Kiely, 6/18).

The president continued that theme Saturday. The Wall Street Journal reports: "President Barack Obama on Saturday used his weekly radio address to blast Republicans for blocking attempts to allow votes on legislation that would extend jobless benefits and raise the liability for oil companies that harm the environment. Obama, in a twist to his frequent business-as-usual criticism of Washington, said he is disappointed to see a 'dreary and familiar politics get in the way of our ability to move forward on a series of critical issues that have a direct impact on people's lives'" (Favole, 6/19).

Meanwhile, the agency that runs Medicare, the Centers for Medicare and Medicaid Services, began paying doctors 21 percent less Friday, MedPage Today reports. "The lower reimbursement rate technically went into effect on June 1, but CMS had announced that it would not process claims for medical services delivered after the deadline, giving Congress additional time to block the 21% cut. This most recent grace period -- CMS has issued four such reprieves this year -- expired on June 17" (Walker, 6/18).

That brought concerns from doctors and advocacy groups. The Los Angeles Times reported: "Doctors complained that the fee cut would take effect anyway because the House has not yet approved the bill, so claims have begun to be processed on the reduced rate schedule. 'This is no way to run a major health coverage program - already the instability caused by repeated short-term delays is taking its toll,' said Cecil B. Wilson, president of the American Medical Assn" (Hook, 6/19).

The Associated Press: "AARP, the seniors' lobby, called the cut 'unprecedented' and 'dangerous' even if it's only temporary. Nancy LeaMond, the group's executive vice president, warned it would undermine confidence in the stability of the giant health care program for 46 million elderly and disabled people. 'This cut creates a dangerous atmosphere for seniors and their doctors, and will contribute to more doctors making the decision already made by some physicians to stop taking Medicare patients,' she said. … The Medicare cuts are required under a 1990s budget-cutting law that Congress has routinely waived. This time, lawmakers' concerns about adding to the deficit held up a deal to allow an exception to enforcement of the law" (Ohlemacher and Alonso-Zaldivar, 6/18).

For earlier coverage of the Senate's action on the jobs bill Thursday, see KHN's Daily Report.


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