Bipartisan group in Congress files bill to scrap ‘doc fix,’ revamp Medicare payments

A bipartisan coalition from both chambers of Congress unveiled a bill Thursday to replace the current way doctors are paid under Medicare with one that rewards providers for high-quality care — a measure that both sides of the political aisle praised as long overdue.

For years, lawmakers had been exploring ways to repeal the 1997 formula used to pay physicians under the health entitlement for seniors and replace it with a more predictable model that rewards the quality, and not the quantity, of care that doctors provide.

The new legislation, introduced by the Senate Finance Committee and House Ways and Means and Energy and Commerce committees, would repeal the Sustainable Growth Rate (SGR) formula, which lawmakers override each year with a fiscal patch known as the “doc fix” — even when the formula calls for a cut.

Over the last 10 years, Congress has spent almost $150 billion on short-term fixes to prevent the cuts, according to the bill’s sponsors.

“This legislation today provides stability for physicians so they will no longer face the uncertainty of massive cuts, but also begins the process of improving how we pay for medical care to focus on positive results for seniors,” Ways and Means Chairman Dave Camp, Michigan Republican, said. “The time to act is now and provide a permanent solution for the Medicare program millions of seniors rely on.”

Earlier this year, the Congressional Budget Office significantly lowered its estimate of what it would cost to repeal the formula — and pay doctors the current rate — from $245 billion over the course of 10 years to $138 billion.

While the drastic reduction in its price tag makes the goal more viable, the question of pinpointing the offsetting cuts remains a difficult one that has yet to be resolved.

“For the first time in many years, we have agreement among the bipartisan leadership of the three Committees that oversee Medicare,” Ways and Means Ranking Member Sander Levin, Michigan Democrat, said. “Now, we have to turn to the thorny issues of offsets.”