Some leading members of Congress took up the cause of trying to ease planned cuts in Medicare pay to physicians last week. But the bipartisan bill to give back $1.25 billion to doctors in 2002 became just another request competing on Capitol Hill for more money to fix a healthcare problem.
More than 65 members of the House immediately signed onto a bill introduced last week that would soften the reduction in next year's Medicare physician fee schedule to .9% below current levels from 5.4% below. The Centers for Medicare and Medicaid Services published the physician rates, scheduled to go into effect on Jan. 1, earlier this month.
"We could theoretically, without this legislation, see communities and seniors without medical services at all, as providers would be encouraged to leave the system," said Rep. W.J. "Billy" Tauzin (R-La.), chairman of the House Energy and Commerce Committee. He was joined in co-sponsoring the legislation by the committee's ranking Democrat, John Dingell of Michigan, and by Michael Bilirakis (R-Fla.) and Sherrod Brown (D-Ohio). Bilirakis and Brown are the chairman and ranking member, respectively, of the Energy and Commerce health subcomittee.
The House bill is similar to legislation introduced in the Senate earlier this month.
The physician pay problem and its roster of supporters will likely have to compete with healthcare causes held dear by other leading lawmakers in the waning weeks of a Congress with scarce funds. Powerful House Ways and Means Chairman William Thomas (R-Calif.) is championing more money for Medicare managed care while Senate Finance Committee leaders Charles Grassley (R-Iowa) and Max Baucus (D-Mont.) favor more support for rural healthcare, according to one Republican House staff member.
Tauzin's bill, the Medicare Physician Payment Fairness Act, includes a provision that money to pay for the bill be offset in other areas of the federal budget.
Further handicapping the physician payment bill is what congressional staff members and lobbyists describe as a heightened backlash against the American Medical Association in response to its lobbying efforts on behalf of the patients' bill of rights earlier this year, a bill unpopular with many Republicans. The Bush administration advised some physician groups to distance themselves from the AMA while communicating with lawmakers about the Medicare pay issue.
AMA President Richard Corlin, M.D., maintains that the association's stance on the patients' bill of rights will not damage its chances on physician pay. "The anger doesn't carry over from one piece of legislation to the next," he said.
Physicians and lawmakers said the methodology used by Medicare to update physician payments, called the Sustainable Growth Rate system, is flawed. The system uses the gross domestic product to peg changes in physician fees each year. House and Senate bills require the Medicare Payment Advisory Commission, which advises Congress on Medicare issues, to recommend fixes to the SGR system by March 2002.