Congressman proposes 'doc fix' extension

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.