With no resolution in sight as of Dec. 21, the nation's doctors continued to wait for a reprieve as Congress had yet to address a looming 26.5% Medicare physician payment cut scheduled to kick in Jan. 1
Healthcare sources on Capitol Hill said they had no reason to believe lawmakers would find a way to delay the Medicare cuts other than as part of a deal resolving or postponing the broader collision of tax hikes and spending reductions scheduled for 2013.
“There is one fiscal train and it's the fiscal-cliff train, so regardless of what we've heard, we haven't seen anything introduced,” said Anders Gilberg, senior vice president at MGMA. “And there's no realistic vehicle outside the fiscal cliff and the tax and spending issues,” he said.
Days before Christmas, the fiscal-cliff negotiations remained stalled after House GOP leaders—short of enough votes—abruptly pulled from the House floor their “Plan B” proposal to avert tax increases. Moments before, the House narrowly approved a measure that would maintain across-the-board cuts to Medicare payments while rolling back other spending reductions scheduled for 2013.
Healthcare providers were quick to line up against the legislation from House Majority Leader Eric Cantor (R-Va.), noting it would maintain about $11 billion in scheduled Medicare payment cuts and also impose steep payment reductions to Medicaid for 2013. Similar to a bill the House passed last May, the Spending Reduction Act of 2012 called for a repeal or defunding of several provisions in the Patient Protection and Affordable Care Act, as well as a proposal to reduce the Medicaid provider assessment to 5.5% from its current level of 6%.
Senate Majority Leader Harry Reid (D-Nev.) vowed the upper chamber would not consider the House's sequester bill, while the White House promised a veto if the president is presented with it.
Meanwhile, the physician community was left wondering if the nearly 27% cut will take effect. On Dec. 19, the American Medical Association sent a letter to members of Congress asking for lawmakers to act immediately after an announcement from the CMS indicated there would be no delay in the processing of claims payments under the Medicare physician fee schedule. The CMS also said it would provide a payment status update to providers on or before Jan. 11, 2013.
MGMA's Gilberg said he expects the duration of any doc fix to mirror whatever fiscal-cliff solution policymakers develop. So, for instance, if Congress approves a one-month delay on the spending cuts scheduled under the Budget Control Act's sequestration process, the SGR could be delayed for the same period.
“This is where I am positive,” Gilberg said. “It is very, very much on the table to have an SGR fix. It's not like anybody has forgotten about the critical importance of dealing with this issue and the access problems that would ensue if we let a cut of this magnitude go into effect.”
Editor's note: Follow breaking news coverage of the fiscal negotiations at ModernHealthcare.com.