House GOP agrees to doc pay-rate extension, Gingrey says

House Republican leaders have agreed to include a two-year extension of the current Medicare physician pay rates, including a 1% increase, in a large legislative package primarily aimed at extending an expiring payroll tax cut, according to a Republican healthcare leader.

Rep. Phil Gingrey (R-Ga.), co-chair of the GOP Doctors Caucus, said in an interview that the two-year $38 billion extension of current rates that were scheduled to drop 27.4% on Jan. 1 “was not ideal” but was better than the sometimes months-long extensions that have occurred over the past two years as Medicare's sustainable growth-rate funding formula has repeatedly called for steep physician payment cuts. Republican leaders had considered shorter cuts, he said, but the caucus urged two years as the shortest.

The legislative package including the SGR patch would derive its funding through a variety of changes, including a provision limiting Medicare benefits for high-income beneficiaries.

Gingrey said a permanent fix to the Medicare payment formula was not possible this year because much of legislators' time was consumed with deficit-reduction talks. Congress would aim to develop a permanent replacement for the SGR formula over the next two years, he said. Gingrey's preferred approach would replace fee-for-service payments with reimbursing physicians for meeting treatment benchmarks developed by medical societies.

“This has to be driven by the medical experts and those are the physicians,” said Gingrey, a physician.

The House is expected to vote on the package Dec. 13 before a planned Dec. 19 adjournment for the holidays. However, Gingrey said it is unknown whether the Senate would support the House package.

Meanwhile, a letter from House members (PDF) asking leaders not to include hospital rehabilitation cuts in any end of the year funding scheme reached 79 Republicans and Democrats on Thursday morning, according to a congressional staffer. It was unclear whether such cuts were included among funding sources for the SGR and tax cut extension package.