Medicare Doc Fix Unlikely In 2013, Attorney Says

Legislation signed by President Obama reopening the federal government and extending its borrowing authority is likely to delay congressional action on a Medicare physician pay fix until 2014, according to a prominent Washington attorney.

Eric Zimmerman, a partner at McDermott Will & Emery, said in a news release that because the law (Pub. L. No.113-46) keeps the government funded until Jan. 15, 2014, there will be little incentive for Congress to approve either a permanent or temporary fix before then. Without congressional intervention, physicians’ Medicare reimbursement will be reduced about 24 percent Jan. 1, 2014.

The possibility of the cut being implemented “ likely will not be enough to induce Congress to act independently on an [Sustainable Growth Rate] bill, other than perhaps to provide a short-term (e.g., 2 or 3 week) patch to carry physician payments at 2013 levels up to January 15th or so,” Zimmerman said.

The law also established a House/Senate conference committee that will try to craft a budget agreement by mid-December, so “it is highly unlikely that Congress would try to separately resolve SGR and other expiring Medicare programs through a separate, earlier process,” Zimmerman said. “While this is bad news for those who would be adversely affected by decreasing physician payments and a longer period before Congress extends other expiring provisions, it provides some additional time to those sectors that expected to contribute heavily in any bill requiring Medicare offsets,” he added.

The House Energy and Commerce Committee in July approved legislation (H.R. 2810) permanently overhauling Medicare’s physician payment system. The Senate Finance Committee, which has jurisdiction over the issue in that chamber, has yet to produce a plan.