House Overwhelmingly Passes "Doc Fix"

United States CongressUPDATE: There will be no “doc fix” until mid-April. The Senate adjourned for spring break on Friday morning without taking up legislation to permanently repeal the SGR formula.

This doesn't mean physicians will face a 21% cut on April 1. CMS has indicated that it can delay processing claims for a period of time in order to keep the cut from being implemented. 

It is expected that the Senate will pass the legislation when they return from break April 13th. "We'll return to it very quickly when we get back," Senator Mitch McConnell told reporters Friday morning. "I think there's every reason to believe it's going to pass the Senate by a very large majority.”

President Obama has also expressed his support for the bill. “I’ve got my pen ready to sign a good bipartisan bill,” the president said during a speech at the White House.


The House overwhelmingly passed a measure yesterday (392-37) to reformulate how Medicare reimburses physicians and other providers in a rare bipartisan alliance between the top two leaders.

Without congressional action, doctors would face a 21% cut in payments starting April 1. The formula, which dates back to a 1997 law designed to rein in the growth of Medicare’s costs, became unworkable over the years, forcing Congress to override cuts through temporary patches. But a long-term fix always seemed out of reach until now.  The hangup has always been how to pay for it.  This bill will cost$214 billion - two-thirds of which would be picked up by taxpayers primarily by increased cost shifting to Medicare beneficiaries (about 30% of beneficiaries paying income-tested premiums will see an increase in their premiums).  The rest is paid for by reimbursement cuts to primarily institutional providers.

The bill also includes two years of funding for the Children's Health Insurance Program, whose funding expires at the end of September, and $7.2 billion for community health centers over two years—avoiding a September expiration of a funding program set up through the Affordable Care Act.

There is also a provisional that permanently extends a program that subsidizes premiums for low-income Medicare beneficiaries.

The bill goes to the Senate today where it is likely to pass.  If passed, the bill will proceed to President Obama who will almost certainly sign the bill into law.  The President has published a letter of support for the bill.

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