Sen. Orrin Hatch (R-Utah) said during a brief interview last week that “people aren't together yet” on resolving outstanding healthcare policies. “It will have to be brought to a head; that's for sure.”
The election's outcome is expected to give the victorious party the upper hand during a post-election legislative session, during which Congress will aim to resolve outstanding legislative business. “It will be a political scrum of the highest magnitude after this election,” Rep. Ed Markey (D-Mass.) said in an interview.
In the current politically uncertain environment, one expectation is that Congress will approve only a one-year reprieve from any of the healthcare cuts, instead of comprehensively resolving any of them.
Rep. Michael Burgess (R-Texas), a physician, told Modern Healthcare that he expects passage of a doc fix by year's end and suggested a possible duration for the temporary patch. “I would think a year,” he said. “There's no point in doing anything less than a year because it just causes trouble.”
There also are indications that the post-election negotiations will include some refighting of the budget battle that occurred last year. Physicians and hospitals are worried that Congress will patch the sequester cuts triggered by the Budget Control Act with other policy tweaks that providers oppose.
A popular source for healthcare spending cuts among some members of Congress is the nonpartisan Medicare Payment Advisory Commission, which has offered a number of ways to reduce Medicare spending over the years. Among MedPAC cuts drawing particular concern from hospitals is a proposal that Medicare reduce payment rates for hospital evaluation and management outpatient office visits to the amount provided in physicians' offices.
“This would reduce the hospital payment by at least 71% for 10 of the most common outpatient hospital services,” hospital groups said in a Sept. 12 letter to members of Congress blasting the proposal.
Other providers are worried that Congress again will cut funding for initiatives launched by the Patient Protection and Affordable Care Act. For example, legislators cut $5 billion from the law's Prevention and Public Health Fund to help fund a legislative package in February 2012 that staved off the Medicare physician fee cut until January 2013.