Congress has officially ended the “doc fix” era.
The Senate easily passed bipartisan legislation Tuesday night repealing a flawed Medicare payment formula that has long flummoxed Congress and serves as a striking example of how difficult it is these days for lawmakers to reach consensus even with a common goal in mind.
Sen. Ron Wyden, D-Oregon, praised the bill for retiring “the outdated, inefficiency-rewarding, commonsense-defying Medicare reimbursement system.”
“This is an important night for the Senate, and it’s going to long be remembered,” he said.
“This has been a long ordeal,” remarked Sen. Orrin Hatch, R-Utah.
Senators passed the bill just a few hours before midnight, averting a 21 percent payment to Medicare doctors that everyone agrees would have been disastrous for seniors, and replacing it with a system that rewards doctors for quality of care. Just eight Republicans opposed it.
They voted down six amendments to the bill that would have complicated its fate by requiring the House to approve the new version before President Obama could sign it — a rancorous task that would have delayed or derailed final passage. The White House has said it backs the plan.
A failed amendment offered by Democratic Sen. Michael Bennet of Colorado would have included in the legislation funding for the Children’s Health Insurance Program for four years instead of just two, one of the final sticking points during negotiations.
Members also rejected an amendment offered by Sen. Mike Lee, R-Utah, to fully pay for the legislation by applying what’s popularly known as “pay as you go” rules, and one from Sen. John Cornyn, R-Texas, to repeal the Affordable Care Act’s individual mandate.
Doctors, hospitals and other health providers, who have long wished for a permanent solution, applauded the move.
“Passage of this historic legislation finally brings an end to an era of uncertainty for Medicare beneficiaries and their physicians — facilitating the implementation of innovative care models that will improve care quality and lower costs,” said James Madara, CEO of the American Medical Association. “Patients will be able to get the care they need and deserve.”
Every year since 2004, Congress has sidestepped the cuts mandated by Medicare’s Sustainable Growth Rate formula with a temporary “doc fix.” Lawmakers have long talked about the need to ditch it permanently, but were unable to agree on how to do it or pay for it.
House and Senate staffers spent much of 2013 writing and merging separate plans to replace the SGR with a payment system in which doctors can get higher reimbursements for meeting new benchmarks for better care. Committee leaders in both chambers rolled out an agreement a year ago, but were still divided over how to pay for it.
In March, the House passed the bipartisan plan but agreed to pay for just one-third of the roughly $210 billion cost, mostly by raising premiums for wealthy seniors and lowering expected payment increases for long term care hospitals and nursing facilities.
The cuts to Medicare doctors were technically slated to start April 1, but the federal government was able to postpone them until Congress returned to Washington Monday from a two-week break.
