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Former Medicare administrators asked to offer doc-pay ‘fix'


By Rich Daly
Posted: May 10, 2012 - 1:45 pm ET
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Updated May 11, 10:45 a.m. ET

The senior Democratic senator overseeing Medicare legislation directed four of the program's former administrators to develop within a month both a short-term and a long-term “fix” to the program's physician payment system, which faces a 30.9% cut in January.

The directive by Sen. Max Baucus (D-Mont.), chairman of the Senate Finance Committee, followed a discussion by his panel of the chief barriers and opportunities to overhauling that much-maligned payment system. However, Baucus told reporters afterward that he was not committing to either introducing the former administrators' recommendations as legislation or introducing his own plan this year to overhaul the payment system.

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The four former administrators of the CMS and its predecessor agency—who worked for both Republican and Democratic presidents—were Gail Wilensky, Bruce Vladeck, Thomas Scully and Dr. Mark McClellan. They said afterward that they were cautiously optimistic that they would find agreement on physician payment overhauls.

Wilensky, now a senior fellow at Project Hope, said the quickly approaching January cut required by the sustainable growth-rate formula limits the groups short-term options. “The question I'll have to think hard about is whether there is anything we can come up with other than payfors” for a short-term delay in the scheduled physician pay cut, said Wilensky, in a brief interview after the discussion.

McClellan, now a senior fellow at the Brookings Institution, said the quickly advancing FDA user fee reauthorization legislation gives him hope that similarly bipartisan agreement is possible to overhaul the Medicare physician payment system.

"Let's face it, we're not in a stable situation now and something has to happen by early next year,” McClellan said in an interview.

The actions by the Senate Finance committee were praised by the American Medical Association in a statement. “Eliminating this problem is especially important as we work to enhance the way health care is delivered in our nation, with an increased focus on care coordination that ensures quality care for patients while addressing rising costs," said Dr. Peter Carmel, AMA president. "These changes require physician practices to be financially stable, which is difficult due to payments that are well below increases in practice costs and the ongoing threat of drastic cuts, such as the one of about 30% now scheduled for Jan. 1."


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