Congressman proposes 'doc fix' extension

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CMS might need six months before starting to reprocess nursing home payment claims, agency says
CMS might need six months before starting to reprocess nursing home payment claims, agency says

A newly proposed bill in the U.S. House would extend Medicare physician payment rates for one year while legislators work to devise a more manageable alternative to the existing formula.

The “Assuring Medicare Stability and Access for Seniors Act of 2012” (H.R. 6142) was introduced by Rep. Michael Burgess (R-TX). “While this legislation will provide a one-year extension, Congress must continue to work towards a permanent fix that will solve the issue once and for all, and this bill provides that time,” Burgess said in a statement Friday.

The Medicare payment formula for physicians' services — which is known as the Sustainable Growth Rate — is used to make sure that annual increases in the expense per Medicare beneficiary do not exceed the growth of the gross domestic product. But because it's only a temporary “doc fix,” Congress has had to act every year recently to stave off a 30% reduction in Medicare physician payments.

Long-term care advocates are concerned that potential cuts in physician pay could hinder LTC residents' access to physicians. Beyond that, they also worry that officials eventually will fund a doc-pay solution with funds that might otherwise have been intended for long-term care.

The bill has been referred to the House Energy and Commerce and Ways and Means committees.

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