Healthcare Business News

‘Doc fix' clears House; cuts still loom

By Matthew DoBias
Posted: May 28, 2010 - 2:30 pm ET

The House voted 215-204 to approve a greatly pared-down legislative package that includes a $4.5 billion cut to hospitals, and separately 245-171 to replace a 21.2% cut in Medicare physician payments with 19 months of positive updates.

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The two measures were once part of the same legislative package, but were split after the combined bill proved too costly for a bloc of fiscally conservative Democrats.

Even so, the House action on the so-called "doc fix" for Medicare physican reimbursement could prove toothless in the short term. The Senate adjourned early Friday without taking up either bill, meaning the soonest they'll consider the measures is after their weeklong Memorial Day recess.

The cuts officially take hold on June 1, but CMS said it would hold claims for at least 10 days.

Under the $22.9 billion physician payment measure, doctors would see a 2.2% update for the balance of the year, and a 1% increase in 2011. But they'll face a 33% cut in 2012, which the American Medical Association and other physician lobbies railed against.

“Enough is enough,” AMA President J. James Rohack said in a written statement. “Nine times in eight years Congress has delayed the cut and not fixed the problem. Congress needs to buckle down, stop growing the problem and fix it once and for all to save Medicare and TRICARE programs for America's seniors and military families.”

The hospital cuts come from a refiguring of what's known as the “72-hour rule.” The provision expands the list of services that are not eligible for reimbursement under the Medicare rule. Essentially, it bars the unbundling of payments for therapeutic services unrelated to hospital admissions if they are performed within three days of an admission.



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