Will House Republicans Successfully Repeal the Medicare “Doc Fix” Law?

Feb 13 (Reuters) – Republicans in the U.S. House of Representatives will seek a permanent solution to scheduled steep cuts in physician payments from the federal Medicare health insurance plan for retirees and disabled people, a House committee chairman said on Wednesday.

Rep. Fred Upton, chairman of the House Energy and Commerce Committee, told doctors he hopes to send so-called “Doc Fix” legislation to the House floor this summer that would repeal payment reductions enacted in 1997 as part of a law to balance the federal budget.

The 16-year-old “sustainable growth rate” (SGR) provision calls for reductions in doctor pay as a way to control spending by Medicare. Congress has prevented the SGR from taking effect through temporary measures, but that has run up the fiscal and political costs of finding a permanent solution.

U.S. Doctors have voiced frustration about uncertainty caused by the persistent threat of steep reductions in Medicare reimbursement for their services. Some have even threatened to stop serving Medicare patients.

Upton said he believes the nonpartisan Congressional Budget Office has opened “a window of opportunity” for change. The budget office recently lowered its cost estimate for a long-term SGR fix to $138 billion, from $245 billion last August, due to lower Medicare spending on physician services.

“It’s obviously a very large amount but a smaller mountain to climb,” the Michigan Republican said in a speech to the American Medical Association (AMA).

“Our goal is to get it done this year, to actually have it on the House floor before the end of the summer — July or the first week of August.”

Upton said he would seek support from Democrats in the Republican-controlled House to achieve a bipartisan bill that could muster support in the Democratic-run Senate.

He offered no specifics on how his bill would pay for the cost of repealing the SGR.

In the latest episode of the cat-and-mouse game, physicians escaped a 27 percent reduction in Medicare payments scheduled for Jan. 1, 2013, when Congress enacted a one-year $25 billion Doc Fix as part of its fiscal cliff legislation. The measure holds physician payments unchanged.

Upton and other leading Republicans on his panel have released a legislative blueprint that calls for freezing doctor payment rates for 10 years and basing future increases on their willingness to embrace methods to improve the quality and efficiency of care.

A bill introduced this month by House Democrat Allyson Schwartz and Republican Joe Heck would allow four years of payment increases while new payment and delivery models are vigorously tested.

An AMA proposal calls for a similar transition period, during which physicians would be rewarded for participating in new methods of care delivery.

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