Shorter-term 'doc fix' expected

Physician groups said they expect a shorter-term patch to Medicare physician payments than first proposed as wide-ranging legislation moved into the fast lane late Tuesday in advance of a possible House vote today.

Healthcare lobbyists tracking the ever-shifting “doc fix” said they expect an 18-month pay freeze—an about-face from at least two other proposals that would have given doctors a slight update for a year and a half while temporarily refiguring the formula Medicare uses to determine payments.

Physicians face a 21% pay cut by the end of the month if Congress doesn't first step in.

“We don't want this Armageddon to happen on June 1 either,” said John Crosby, executive director of the American Osteopathic Association. “So a shorter term fix—if that's all we can get right now—we'll take it. But, we would prefer more time in order to come up with a permanent solution.”

The final legislative flourishes come after the House Rules Committee fast tracked the bill late Tuesday night, allowing for a vote as soon as today on a $274 billion package of Medicare and safety-net healthcare provisions, as well as a number of tax measures.

The Senate could vote on the package as early as Friday.

All along, however, almost all Republicans and a good number of Democrats have been concerned about the bill's price tag, which congressional actuaries said would add $134 billion to the national debt.

Much of the cost comes from a proposed 3.5-year refiguring of physician payments, which the Congressional Budget Office estimates would add $64.6 billion to the deficit.

Other big-ticket items include a $47 billion measure to extend COBRA premium subsidies for the unemployed through the end of the year and $24 billion to keep a higher level of federal Medicaid payments in place.