Congress mulls Medicaid-Medicare pay parity, and end of 'doc fixes'

Offering graduate medical education funding to nursing homes could help ready physicians for aging p
Offering graduate medical education funding to nursing homes could help ready physicians for aging p

Long-term care providers are closely monitoring two major lawmaking efforts in Washington this week that have both chambers of Congress debating a plan to end annual Medicare cuts and abolish painful “fixes” to the Medicare physician payment formula. Senators are also mulling another deal that would pay Medicaid doctors similar to their Medicare counterparts. The success of one bill may depend on that of the other.

Physician groups are optimistic the doc fix bill has a good chance of passing after surviving what a lot of horse trading on the floors of both the Senate and the House. Senate Finance Committee Chairman Orrin Hatch (R-UT) called the Sustainable Growth Rate, which has compelled the creation of annual “doc fixes” merely “phony bookkeeping.”

Meanwhile, the biggest questions on Capitol Hill remain: How would any plan be paid for, and do lawmakers have the stomach to add to the federal deficit?

Even though the doc fix bill is cloaked in secrecy (it's referred to as a “package”), observers say momentum is building to finally resolve the annual Medicare cuts crisis and stopgap measures that stave off Medicare cuts for physicians. With only 15 days to go until the deadline for 2015 physician payment cuts, supporters said they were optimistic.

Among them is Rep. John Fleming (R-LA), co-chairman of the GOP Doctors Caucus, who told Capitol Hill reporters Thursday that he was confident the legislation would arrive on President Obama's desk even after what he acknowledges will be a tough sell with fiscal conservatives. Club for Growth and Heritage Action, both of which have vowed to help the bill fail if it isn't fully funded, according to news reports.

The permanent fix has a $174 billion price tag, but little is known where the money will come from. Observers say Democrats may be enticed to support the legislation in exchange for commitments to extend funding for the Child Health Insurance Program (CHIP) or the Medicaid payment bump for doctors.

It's the latter one that seems to be anyone's guess, according to observers.

Democratic Sens. Patty Murray (Washington) and Sherrod Brown (Ohio) want to resurrect an expired provision of the Affordable Care Act that allows parity in provider payments under the bill they're sponsoring to increase physician Medicaid rates to the same level as Medicare rates, according to published reports.

Among their drivers: the explosion of Medicaid enrollees over the past four years under Obamacare and the fact that physicians in most states earn as much as 60% less than they do under Medicare. The Centers for Medicare & Medicaid Services estimates the measure would cost $11 billion.

Long-term care providers are closely monitoring two major lawmaking efforts in Washington this week that have both chambers of Congress debating a plan to end annual Medicare cuts and abolish painful “fixes” to the Medicare physician payment formula. Senators are also mulling another deal that would pay Medicaid doctors similar to their Medicare counterparts.