No HME Cuts in House Doc Fix

WASHINGTON — Physicians got closer to a so-called “doc
fix” Nov. 19 when the House passed H.R. 3961, a measure that would
spare them from a planned 21 percent Medicare pay cut in 2010 and
“fix” the program’s current physician payment formula.

Vigorous lobbying on the part of the American Medical
Association largely focused on questions of patient access, an
argument also used by advocates in the home care industry when
describing the likely effects of competitive bidding. Last month,
the AMA issued a list of “patient access hot spots” including 21
states and the District of Columbia where they said access to care
and choice of physician is already threatened for Medicare
patients.

Without the fix, according to AMA President-elect Cecil Wilson,
MD, physicians face Medicare cuts of about 40 percent over the next
five years. “In two years, the baby boomers will begin to reach
Medicare age, and they will expect access to high-quality medical
care to stay healthy and active as they age,” Wilson said in a
release. “Physicians want to provide this care, but they need to
know that Medicare will cover the cost of providing 21st century
medical care.”

The $210-billion Medicare Physician Payment Reform Act of 2009
would cancel the scheduled pay cut set for January, boost
physicians’ pay by 1.2 percent in 2010 and permanently reform the
sustainable-growth formula used to calculate reimbursement rates.
The bill’s cost, however, is not offset by cuts elsewhere. The good
news for home care providers is that the bill includes no cuts to
HME to make up for the revenue shortfall.

When the bill goes to the Senate for consideration, advocates
warn that things could change. That chamber rejected a similar bill
on a procedural vote in October.

The Senate health reform bill includes a short-term fix that
would provide doctors with a 0.5 percent payment update in 2010,
but Majority Leader Harry Reid, D-Nev., has indicated he hopes to
take up a permanent fix after health reform legislation is wrapped
up. Meanwhile, press reports confirmed Minority Leader Mitch
McConnell, R-Ky., believed the Senate would ultimately reject the
House bill.

“Fixing the Medicare physician payment formula once and for all
is an essential element of comprehensive health reform,” AMA
President J. James Rohack, MD, said in a statement. “Congress needs
to fulfill its current commitments as it considers expanding its
obligations. Physicians must be assured of stable payments so they
can continue to care for seniors, baby boomers and military
families.”