‘Doc Fix’ Is Back

WASHINGTON — The infamous “doc fix” is back. If it becomes
reality, home care advocates again fear the government will come
looking for ways to make up the revenue shortfall.

This time around, the fix would amount to a “freeze” as codified
in the proposed bill S. 1776. The measure would repeal the current
Medicare physician payment system at a cost of about $247 billion
over 10 years.

How does a “freeze” cost money? If Medicare physician
reimbursement is frozen, it means payments will not be
subject to the whopping 21 percent reduction scheduled for 2010.
Spearheaded by Sen. Debbie Stabenow, D-Mich., this year’s so-called
doc fix (dubbed “The Medicare Physicians Fairness Act”) would
freeze doctors’ pay for a decade.

Sen. Kent Conrad, D-N.D., acting chairman of the Senate Budget
Committee, confirmed that he would oppose the fix unless it was
properly paid for. “It adds to the debt without a pay-for, and that
was not in the budget agreement,” Conrad told reporters in
reference to the fiscal 2010 Senate budget resolution.

Provider Tom Ryan, president and CEO of Homecare Concepts,
Farmingdale, N.Y., contends that the doc fix battle is yet another
reason the HME industry must continue to espouse its value, get
behind H.R.
3790 to repeal competitive bidding and support the Stand Up for
Homecare public awareness campaign.

“Despite a PR blitz from [the American Medical Association] for
support, I believe the House, which voted for ‘pay-go,’ will oppose
adding [the doc fix] without ‘pay-for,’” said Ryan. “What that
means for HME is that we are vulnerable, oxygen is vulnerable, and
the present Senate finance bill has many embedded cuts
already.”

The AMA PR blitz that Ryan referred to can be seen in recent
press releases issued by the organization. Like last year, the
clock is running on the physician pay cut, which is scheduled to
take effect on Jan 1, 2010. According to the AMA Web site, the 21
percent cut will grow to approximately 40 percent by 2016.

“Persistent, looming cuts and low payments reduce access to care
and keep physicians from participating in quality initiatives and
purchasing health information technology,” AMA officials said.
“Medicare payments should cover the increasing cost of providing
care so that seniors can be assured of continued access to
physician care.”