A permanent fix to prevent doctors from losing a chunk of their Medicare payments has yet to emerge from Congress, even though lawmakers have to get something in place in just a few short weeks.
Legislation has been introduced in the House and Senate to repeal the sustainable growth rate formula that determines how much doctors get back from Medicare. However, sources told the Washington Examiner there is no path forward in Congress just yet on a permanent fix, but both the House and Senate are working on it.
If no action is taken by the end of this month, doctor reimbursements will be cut by 21 percent. If lawmakers aren’t able to come to a permanent solution, another option is to pass another short-term patch, one source said.
That option isn’t new to Congress. So far lawmakers have passed a short-term patch 17 separate times.
A source told the Examiner that a sticking point in the Senate remains how to offset the cost of a permanent fix. The Congressional Budget Office said last month that freezing doctor payment rates at their current levels would cost $137 billion over the next decade.
One senator was optimistic that a permanent fix could be reached.
“I’ve been in Congress long enough to be skeptical of rumors, but what we are hearing from the House suggests there is real movement to fully repeal and replace the flawed formula,” said Sen. Ron Wyden, D-Ore., ranking member of the Senate Finance Committee, on Wednesday.
The formula was put into place in 1997 to rein in Medicare spending. However, the formula has recommended cuts to doctor reimbursements.
There is general bipartisan agreement that the formula is flawed and a permanent fix is needed. However, Congress never seems to agree on a permanent solution.
Lawmakers passed the current one-year patch in March 2014. Legislation for a permanent fix was scuttled at the last minute due to a rider to delay Obamacare’s individual mandate penalty, which went into effect last year.
Wyden noted that the formula isn’t the only pressing healthcare deadline facing Congress. By the end of this month, the House and the Senate need to reauthorize funding for the Children’s Health Insurance Program, which offers health coverage to more than 10 million children.
Republicans and Democrats are split over how to reauthorize the program. Republican senators have floated a bill that would cut coverage for families that earn more than 300 percent more than the federal poverty line, and Democrats are pushing a straight reauthorization.
Democrats have floated the idea of rolling in the children’s plan reauthorization with the permanent fix for the sustainable growth rate.
