Key members of the doctors’ lobby are “extremely disappointed” the Senate did not take up a House-passed overhaul to Medicare’s payment system before skipping town for spring break.
In a statement Friday, the American Medical Association said the upper chamber has exposed doctors to a 21-percent pay cut in April, although senators effectively have until mid-month to act because of a built-in delay in how the Medicare agency processes claims.
“Unfortunately, there really isn’t much we can do if things go beyond the 14th,” the AMA told The Washington Times. “The Senate has to pass the bill by then or the 21-percent cut will go into effect.”
The organization and a leading House Republican registered their anger one day after the normally fractious House overwhelmingly passed a bipartisan bill to permanently cancel Medicare budget cuts that eat into physicians’ pay.
It repeals the nearly two-decade-old Sustainable Growth Rate (SGR), which was designed to rein in ballooning deficits by limiting the growth of payments to doctors who treat Medicare patients.
Congress has never allowed the cuts to go into effect, regularly passing short-term fixes — sometimes offset by other cuts, and sometimes tacked onto the deficit.
The Senate was tied up Thursday with a marathon set of budget votes that lasted well into the night. They are not scheduled to reconvene until April 13, meaning the administration may have to start paying doctors at reduced rates under existing law.
The Centers for Medicare and Medicaid Services (CMS) informed providers on Tuesday that the cut would take effect April 1, although it cannot process any electronic claims until 14 days after they receive them — or no sooner than 29 days after receipt of paper claims.
“They can handle a two-week gap [at CMS],” Senate Majority Leader Mitch McConnell, Kentucky Republican, said during Friday’s wee hours. “We’ll turn to this legislation very quickly when we get back. I think there’s every reason to believe it’s going to pass the Senate by a very large majority.”
A McConnell spokesman said there wasn’t unanimous consent to pass the bill in the night, so it had to be taken up swiftly upon their return.
Senate Democrats have complained the package re-authorized the Children’s Health Insurance Program for two years instead of four.
They also didn’t like the inclusion of so-called Hyde restrictions on spending federal money for abortion in the bill’s funding package for community health centers, although those concerns started to wane in recent days.
And conservative Republicans, particularly Sen. Ben Sasse of Nebraska, worried the legislation would raise the deficit without establishing more far-reaching reforms to Medicare.
Nonetheless, Senate leaders said they hope to leverage an emphatic 392-37 vote in the House to get it passed in their chamber.
“We’re willing to move forward, I’m disappointed that we may not be able to get it done tonight,” Senate Minority Leader Harry Reid, Nevada Democrat, said early Friday. “I sure wish we could. If we can’t, I hope the majority leader will move to this matter as soon as we get back here after the recess.”
Rep. Kevin Brady, Texas Republican who chairs the Ways and Means Committee’s health panel, said Friday the Senate “shouldn’t have left the building without acting.”
“I embrace the assurances they’ll act next month, but it’s hard to find an adequate reason for leaving our local Medicare seniors and doctors in yet another lurch, or delaying the first real reforms to save Medicare for the long term,” he said.
The situation is not unprecedented. In 2010, Congress failed three times to override payments cuts before the prior patch expired, the Congressional Research Service said in a report last week.
Lawmakers moved quickly enough in the first two instances to avoid impacting doctors, because of CMS’ delay in processing claims, but the third override had to be retroactive for 25 days, researchers said.
The Congressional Budget Office estimated the legislation will cost $214 billion over the coming decade, with about $140 billion tacked onto the deficit and the rest covered by wealthier Medicare recipients and providers such as hospitals.
The American Hospital Association, which did not like seeing its members’ rates used as an offset to pay for the package, nonetheless encouraged Congress to finish the job.
“We are hopeful that the Senate take up [the bill] when they return from recess and quickly pass it to send to the president for his signature,” AHA spokeswoman Marie Watteau said.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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