Two House GOP Doctors Craft Draft Bill For a New Medicare Physician Pay System

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By Steve Teske  

Two members of the House GOP Doctors Caucus have produced draft legislation for creating a new Medicare payment system for doctors that includes a five-year period under which physicians' payment would be updated annually while a new reimbursement regime is developed.

The 27-page bill being circulated by Reps. Tom Price (R-Ga.) and Charles Boustany (R-La.) includes a five-year period in which physicians' annual Medicare reimbursement would be tied to a medical economic index and a four-year time frame for Congress to consider legislation implementing a new reimbursement system.

The draft bill is the second to be produced by House lawmakers in recent weeks. Reps. Allyson Y. Schwartz (D-Pa.) and Joseph J. Heck (R-Nev.) May 9 introduced the Medicare Physician Payment Innovation Act (H.R. 5707), which also contains a five-year transition to a new payment system (23 MCR 550, 5/11/12).

No Cost Offset.

H.R. 5707 is paid for by estimated savings from the wars in Afghanistan and Iraq. In a “Dear Colleague” letter, Price and Boustany said their bill is not yet paid for.

Dear Colleague letters are sent among lawmakers to seek support for legislation or for other purposes.

“While budget experts have identified a wide variety of offsets to fund reform, we have chosen not to include one for the purposes of this draft,” the letter said.

The cost of a permanent physician payment fix has been estimated at more than $300 billion over 10 years. The high cost associated with a permanent fix has led Congress to produce a series of temporary pay patches over the last eight years. The latest patch expires Jan. 1, 2013. Unless Congress acts by then, physicians' Medicare reimbursement will be cut about 30 percent.

In their Dear Colleague letter, Price and Boustany said they “continue to hear from constituents who have difficulty finding a physician who accepts new Medicare patients. The unrealistic Medicare physician payment formula exacerbates this problem by requiring automatic annual cuts that would force seniors to wait longer and travel further for care.”

The lawmakers have asked industry stakeholders to provide feedback on this proposal throughout the year, a Boustany aide told BNA June 7. The aide said the pair have no immediate plans to introduce legislation on the subject.

The bill contains numerous other provisions, including one that would limit malpractice lawsuits against physicians following best practice guidelines established by the Department of Health and Human Services.

By Steve Teske  

The draft bill is at

The Dear Colleague letter from Price and Boustany is at