Given the scope of PPACA, many physicians were disappointed that Congress did not include a long-term fix to the Medicare sustainable growth rate formula. As reported in an August 23, 2010 Annals of Internal Medicine article, White House officials acknowledged the physician disappointment, but said that “physicians should not let their frustration over the sustainable growth rate distract them from the improvements that health care reform delivers to their patients and the profession.”
With the December 1st deadline looming for a potential 23% decrease in Medicare reimbursement and an additional 1.9% decrease beginning on January 1, 2011 absent action by Congress, it is likely that the majority of physicians are, indeed, distracted. On November 18th, the Physician Payment and Therapy Relief Act of 2010 was approved by the unanimous consent of the Senate, which, if passed, would cancel the decrease in Medicare reimbursement through December 31st. In a November 18th press release from Senate Finance Committee Chairman Max Baucus and Committee Ranking Member Chuck Grassley, Senator Baucus and Senator Grassley agreed that they would “together pursue a year-long fix to the formula that could be enacted before the month-long patch expires.”
In addition, on November 18th the Medicare Physician Payment Update Extension Act (H.R. 6427) was introduced in the House of Representatives, which, if passed, would cancel the decrease in Medicare reimbursement, and increase Medicare reimbursement to physicians by 1% effective December 1, 2010 through December 31, 2011. The House of Representatives’ bill has been referred to the Committee on Energy and Commerce and the Committees on Ways and Means and the Budget. While Congress still needs to establish a long term fix to the issue of the sustainable growth rate formula, either one of these bills, if passed, will at least provide an interim solution at a time when continued access to physicians by Medicare beneficiaries and the supply of physicians is a critical issue. Physicians will have to wait until after Thanksgiving, though, to know which interim solution is adopted.