Congress appears poised to pass yet another patch to Medicare's unpopular sustainable growth-rate formula for physician payments despite fervent opposition from the American Medical Association, its allies and others.
That would set up another SGR crisis next year, frustrating physician groups that felt closer than ever to permanently resolving the problem.
Monday afternoon, the Senate is expected to consider the 12-month patch, which the House approved Thursday. Opponents seeking permanent repeal lobbied over the weekend to rally opposition. But Hill watchers assume senators, even those opposed to a temporary patch, will pass the measure rather than face the quagmire of how to pay for a permanent fix.
The one-year patch surfaced at the eleventh hour after legislators failed to reach agreement on paying for physician payment reform, at a cost of at least $138 billion over a decade. Without a new patch or a permanent solution, doctors face a potential 24% cut in Medicare payments April 1. The patch would be paid for through a budget gimmick extending Medicare sequester cuts beyond the 10-year window used for budget scoring purposes and through coding changes lowering physician payments.
The deal was cobbled together by House Speaker John Boehner (R-Ohio) and Senate Majority Leader Harry Reid (D-Nev.) to the chagrin of many of their own caucus members. It emerged as part of a Christmas tree bill with a variety of major, unrelated healthcare provisions that pleased some and angered others. Winners seemed to be hospitals in non-Medicaid expansion states and healthcare organizations that weren't ready to implement the complex new ICD-10 coding system on Oct. 1.