Democratic leaders are reintroducing the package but the fee fix has been scaled back from 19 months to six months. However, the new version would still add a 2.2 percent increase in physician fees, but only through Nov. 30.
The total package could to be voted on as early as Friday. But to win passage, Democratic leaders need 60 votes, and they did not even get a majority in Wednesday’s 52-45 vote. A dozen Democratic Senators would need to be won back and two Republicans need to vote for it. Some observers are saying this may take into next week or longer, but if that can be done the House is expected to quickly approve the new bill, since it already approved the earlier version, and the president would sign it.
The 21.3 percent cut officially started on June 1. To give the Senate time to pass the fee-fix, CMS twice ordered intermediaries to delay processing claims, but the second order ends Friday. On Friday, claims for all services since June 1 will be processed with the 21.3 percent cut. If the fee fix passes, it would be retroactive to June 1, and practices would have to recoup the cut funds in a second reimbursement.
If the fee cut goes into effect, physician groups and even President Obama warn of access problems for Medicare beneficiaries. Not only would more physicians limit new Medicare patients but more are expected to opt out of the program. A recent AMA survey showed 17 percent of physicians were limiting their numbers of Medicare patients, partly due to the continuing threat of a fee cut.
The new version of the Senate bill does not reduce funding for state Medicaid programs, which stays at $24 billion. But the bill has been slimmed down by about $20 billion to increase its chances of passage.
Senate Democrats, side-stepping physician organizations’ call for a permanent fee fix, initially proposed a three-and-a-half-year fee fix, then gradually whittled down the length of the fix as opposition to more federal spending hardened.
Read the Hill report on the Medicare physician fee fix.
Read some of Becker’s past stories on this topic
Senate Won’t Meet Tuesday Deadline for Fee-Fix
With Medicare Fee Cut Looming, Physicians Weigh Their Options
Almost One in Five Physicians Limit Medicare Patients in Their Practices
