In congressional tug-of-war, doc-pay fix still in flux

House Majority Leader Eric Cantor (R-Va.) on Monday said the nation's doctors don't need more uncertainty, but that's just what physicians are getting from Congress.

Later today, the House will vote to accept or a reject a Senate-amended version of a payroll tax cut bill that the lower chamber passed last week.

For the nation's healthcare providers, the legislation is significant for including measures that affect Medicare payments to physicians, as well as several extensions to healthcare provisions that are set to expire by year's end. The House version calls for a $38.9 billion, two-year fix to the sustainable growth rate, or SGR, formula that would provide a 1% payment update to the nation's doctors in 2011 and 2013. Meanwhile, the Senate's amended version of that bill would freeze payments to physicians until Feb. 29.

When asked if House members are considering removal of the SGR language from the Senate-amended bill and voting on the SGR measure separately, Rep. Tom Price (R-Ga.), a physician, said, “there are all sorts of discussions about what our posture should be and get the Senate to move in a positive direction.” Price noted that House conferees will convene at 6 p.m. Eastern time, before any votes. Earlier in the day, Cantor was resolute about the House’s position to extend the payroll tax holiday for longer than is called for in the Senate bill.

"We are going to stay here and do our work until we guarantee that no one faces a tax increase in the year ahead," Cantor said in a statement Monday. "No one-middle-class families, workers, employers, doctors-needs more uncertainty in this tough economy, and Washington must not ignore them," he continued. "The president has said it would be 'inexcusable' to not extend the payroll tax cut for a year-and we agree."

But resistance from the Senate is fierce, as Senate Majority Leader Harry Reid (D-Nev.) released a statement of his own, saying that he will not re-open negotiations until the House approves the amended bill received support Saturday from 89 senators-including 39 Republicans.

"I have always sought a year-long extension," Reid said in a statement. "I have been trying to forge one for weeks, and I am happy to continue negotiating one once we have made sure middle-class families will not wake up to a tax increase on Jan. 1, according to Reid's statement. "So before we re-open negotiations on a year-long extension, the House of Representatives must protect middle-class families by passing the overwhelmingly bipartisan compromise that Republicans negotiated, and was approved by 90% of the Senate."

Meanwhile, physician groups are in "defensive mode" as their federal reimbursement environment remains cloudy, according to Anders Gilberg, senior vice president of government affairs at the Medical Group Management Association.

"For physician practices--who want to take care of patients, including Medicare patients--it's hard to make sense of the game of chicken that is transpiring in Washington here today," Gilberg said.