The shutdown of the federal government due to the impasse over the budget threatens to derail action on a permanent Medicare physician pay fix, and might even jeopardize a short-term fix, says lobbyist Julius Hobson, a senior policy adviser at Polsinelli in Washington.

Hobson told me Oct. 2 that he has held out hope that the House and Senate committees with jurisdiction over Medicare would finally produce legislation this year permanently fixing Medicare’s physician pay system. But he worried that disagreements between Democrats and Republicans over the budget, the federal debt, and the Affordable Care Act could stop progress on getting a bill through Congress.

 “And here we are,” Hobson  said. “The longer this goes on and the more acrimonious it gets, the harder it will be to get  a permanent fix,” he added. “And if it gets worse, we might not get any doc fix, long-term or short-term.”

Hobson said there is little he can do right now to impress upon lawmakers about the need to pass doc fix legislation. “There are times when some things are above your pay grade. And this is it,” he said.

The House Energy and Commerce Committee in July unanimously passed legislation (H.R. 2810) repealing the sustainable growth rate formula in Medicare’s physician payment system and replacing it with a system based on quality measures and new payment models. The Congressional Budget Office has said the bill would cost $175 billion over 10 years. The House Ways and Means Committee and Senate Finance Committee also are working on doc fix legislation. Lawmakers have yet to say how they would pay for a permanent doc fix. Physicians’ Medicare reimbursement would be reduced 24 percent in 2014 unless Congress acts.