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Senate Finance Committee Chairman Ron Wyden (D-Ore.)
Wyden

Late effort to advance permanent SGR fix fails in Senate


By John N. Frank and Catherine Hollander
Posted: March 31, 2014 - 4:15 pm ET
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(Story updated at 4:22 p.m. ET.)

Senate Finance Committee Chairman Ron Wyden on Monday tried to get the Senate to consider a permanent fix for Medicare's sustainable growth-rate formula for reimbursing physicians only to face immediate objection from Republicans, essentially killing the effort.

Senate Majority Leader Harry Reid (D-Nev.) called on his colleagues to pass a one-year “doc fix” that would avert a drastic cut to Medicare physician pay April 1 and put off the conversion to ICD-10 diagnostic and procedural codes for at least a year.

The Senate was expected to vote on the bill Monday evening.

All eyes were on Wyden (D-Ore.), who opposes the House-passed bill because it allows Congress to again avoid solving the problems raised by Medicare's sustainable growth-rate formula for reimbursing physicians. It would be the 17th patch to the so-called SGR since 1997.

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Wyden asked for unanimous consent to move his bill to repeal and replace the SGR, which he has proposed paying for using savings from winding down military operations in Afghanistan, known as Overseas Contingency Operations funding.

Sen. Jeff Sessions (R-Ala.), the ranking Republican on the Senate Budget Committee, immediately rose to object to Wyden's request, killing the motion. “Budget experts tell us that paying for this through OCO is a mother of gimmicks,” Sessions said. “We could use the savings from the Vietnam War that we're not spending today to pay for this bill, so I would object.”

Sessions countered with a similar motion for the Senate to pass a Republican alternative that would fund the SGR replacement by repealing the individual mandate for insurance coverage required by the Affordable Care Act, which Wyden immediately shot down.

Reid, in remarks delivered from the floor earlier Monday afternoon, urged the Senate to support the temporary fix even though he supports Wyden's ambition to end the cycle of SGR patches

“At this stage, it doesn't appear that's going to happen now,” Reid said, because Democrats and Republicans could not agree on the funding mechanism. “We don't have the votes to do what would be the better thing to do,” Reid said. The House bill, however, reflects a compromise worked out between Reid and House Speaker John Boehner (R-Ohio).

The ICD-10 extension was inserted in the bill when the House voted to approve it last week. Speculation about who lobbied for its inclusion centered around small providers in Republican districts concerned about the costs of implementing ICD-10 by the previous Oct. 1 deadline, but no industry trade group has come out to publicly say they pushed for the extension to be included in the doc-fix bill.

Another line of thought inside the Beltway is that lawmakers added the ICD-10 extension as a sop to industry trade groups—such as the American Medical Association—that oppose another temporary SGR fix. The AMA has argued aggressively for the CMS to change course on the coding implementation. The AMA, however, has been encouraging its members to lobby against the bill. Last week, a group of healthcare industry heavyweights called the Coalition for ICD-10, which includes the American Hospital Association and the Blue Cross and Blue Shield Association, opposed the ICD-10 extension.

—with Catherine Hollander

Follow John N. Frank on Twitter: @MHJFrank


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