Lawmakers raise prospect of stand-alone SGR bill

The co-chairmen of the House GOP Doctors Caucus remained hopeful that House and Senate leaders could resolve their differences on a payroll tax cut bill that would also avert a steep Medicare payment cut to the nation's physicians, but they did not rule out the possibility of a stand-alone bill to address the sustainable growth-rate formula after the new year.

Earlier Tuesday, the House voted on a measure to disagree with a Senate-amended version of an earlier House bill that calls for a two-year fix to the contentious SGR formula. The House's proposed fix, which would cost about $38.9 billion, also would provide a 1% Medicare payment increase to doctors in 2012 and 2013. Meanwhile, the Senate's version would place a freeze on Medicare payments to physicians—effectively a 0% payment update—until Feb. 29.

In their vote Tuesday, House members also called for a formal conference that would require the Senate—which finished its legislative business Saturday—to return so the two chambers could resolve their differences. The House's request for a conference is expected to reach the Senate on Tuesday, and House Speaker John Boehner (R-Ohio) has already announced his conferees. His list includes three House members who all have a stake in the SGR issue: Rep. Tom Price (R-Ga.), a physician; and Reps. Dave Camp (R-Mich.) and Fred Upton (R-Mich.), chairmen of the Ways and Means and Energy and Commerce Committees, respectively. Camp's committee has jurisdiction over the Medicare program, while Upton's panel oversees public health, hospital construction, public and private insurance and food and drugs.

“My hope is the Senate responds to reason and comes back,” Rep. Tim Murphy (R-Pa.), a psychologist and co-chairman of the GOP Doctors Caucus, said Tuesday in between votes. “This is a critically important bill for physicians as is the unemployment compensation and the other issues for other Americans. We have a solution on deck,” he continued. “We hope they will come back and vote on that solution.”

Meanwhile, Rep. Phil Gingrey (R-Ga.), an obstetrician who serves as the caucus's other co-chairman, said he is hopeful that conferees will be able to reach a solution. He also said his caucus emphasized to House leaders that a two-year fix on Medicare physicians be included. “I think it's the least we can do to give certainty to the medical providers if they're going to stay in the Medicare program,” Gingrey said Tuesday in between votes. “They're not going to take a 27% cut and continue seeing seniors.” At issue, he said, is how to pay for provisions in the bill.

“I will say this: If they cannot come to an agreement, that there will be a separate bill on the doctors as soon after we come back as possible—maybe the first bill that we bring up, and it will be retrospective to the 1st of the year,” Gingrey said. “And it would, in all probability, be a stand-alone bill. I hope we don't have to come to that,” he added. “Because that means a lot of claims that are made in January would have to be processed. The last time that happened to us—I think about three years—claims didn't get to the doctors until a year later.”