Senator leaders may now wish they’d pushed to vote on the House-passed “doc fix” deal before they went on a two-week break. While the Senate is expected to turn to the measure on Tuesday, April 14, the two weeks has allowed conservative Senators to build a case against the deal, scraping the exemption from budget laws that would have allowed the bill to ignore the fact that it doesn’t pay for $141 billion in costs.
One report cites that while Senators Jeff Sessions of Alabama and Ben Sasse of Nebraska opposed the bill from the start, they are joined by Senators Mike Lee of Utah, Ted Cruz of Texas and David Vitter of Louisiana. The five Senators intend to offer an amendment to require the bill to be fully funded.
The previous 17 attempts to pass such a bill were all plagued by exactly that kind of requirement – to be fully funded. Other issues could be handled, in both Houses, but the funding appeared to always be the main sticking point.
Also, in a report released just this past Friday, April 10, Paul Spitalnic, the chief actuary for CMS, claimed that “…if not addressed by subsequent legislation, we expect that access to, and quality of, physicians’ services would deteriorate over time for beneficiaries.” In other words, Congress would need to pass more legislation to ensure that Medicare doctors do not lose out in the long run.
In a quickly posted reply to the report, the American Medical Association (AMA) stated that the CMS Office of the Actuary’s (OACT) “report on the estimated effects of H.R. 2 presents an argument for maintaining the status quo that is illogical, flawed and dangerous for patient access to high quality health care.” They claim the report “fails to take into account the long-range negative impact such a drastic payment cut would have on quality and access for Medicare beneficiaries.” Also, they say the reports makes assumptions about continuing upward adjustments for physician fees for many future decades, which is highly unlikely, and not reasonable, especially given the unpredictability of just two of the factors in SGR calculations – GDP growth and Medicare spending growth.
Any Senate amendments or changes to the bill will send it back to the House, signaling further delay.
Meanwhile, CMS issued a notice today, Monday April 13, that “in the absence of additional legislation to avert the [21% decrease in all MPFS payments beginning april 1, 2015], CMS must update payment systems to comply with the law and implement the negative update.“
Other articles about the Senate battle for the SRG Fix:
- The Wall Street Journal: Senate Wrangles Over Medicare-Payments Fix
- Reuters: U.S. Conservatives Threaten Delay To Fixing Medicare Doctor Payments
- Politico Pro: Little Is Clear On Senate’s SGR Vote Schedule
- The Fiscal Times: Medicare ‘Doc Fix’ May Be No Fix at All
- Politico Pro: SGR Bill Risks Doc Pay Problems, CMS Warns