The House on Friday voted 245 to 171 to pass the tax “extenders” legislation, which includes the SGRrrr physician payment fix, but only for a 19-month period extending through Jan. 1, 2011. So, this week the House went from proposing a 5-year fix, to a three-and-a-half year fix, to a two-and-a-half year fix, to this. The direction is NOT good.

Meanwhile, the Senate just adjourned for recess (meaning, I guess, they’re out on the playground now?). They did not choose to vote on this. They may not the votes for a 6-month solution.

So, a 21 percent cut for all doctors in America is in effect today, after 10 years of flat Medicare reimbursement. The plan in the Senate is to take up the issue again when they return on June 7. However, the Senate doesn’t likely have the votes to approve this $25 billion one-and-a-half year extension, so they will require that the House reduce its proposal again we suspect. 

Anticipated Action
The Department of Health and Human Services (HHS) will be holding payment claims for 10 days in June in anticipation of some action on the part of the Senate. My guess is it will be another one- or two-month extension. Enough really is enough here. This is patently ridiculous, and it will mean more and more people will be unable to afford to take on Medicare patients—a disaster for the health and well being of senior citizens.

Fathom this: Congress has accumulated over the past 10 years an estimated but unrecognized addition to the national debt of $371 billion related to kicking the SGR payment formula cuts down the road instead of correcting the formula, and now they’re adding another $25 billion more to the IOU tab if they were to approve the 19 month arrangement. And, nobody gets anything for this. There is not $25 billion in additional health benefits. We’re just paying off a debt to a flawed formula. What other business sector besides medicine would accept this absurdity?

The ACC was quoted in the National Journal this week urging Congress to get past this nightmare issue so we can begin to work on legitimate payment reform and quality improvement nationally. This is ludicrous. Given that so many Americans have been frightened by speculation about health care costs and threats to their own coverage as a result of the health reform legislation, this just makes things worse. Most seniors across the country already know their doctors are running scared. So, what does expanded coverage and access mean when there will be no doctors available to take care of people? I don’t know about you, but I’m getting a little sick of this.

You can read our official ACC statement. As you can imagine AMA is furious about this as well.