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Another missed deadline

April 15, 2010

“These short-term actions are destabilizing medical practices—now on a monthly basis—leaving both physicians and their patients in limbo.”
– America Medical Association Executive VP Michael Maves, MD, in April 12, 2010, letter to Congress.

During the health care debate, Democrats repeatedly promised to provide a permanent fix to the Medicare doctor payment formula known as SGR, which Speaker Nancy Pelosi describes as “very important” to Democrats. “It’s not in this bill, but we will have it soon,” Pelosi said, “we have made a commitment to do this.” If this is how they treat their commitments, Americans’ concerns over this massive government intrusion into health care are well founded.

Far from providing seniors and doctors with stability, this week Democrats will attempt to pass another one-month rate freeze that delays the pending 21 percent cut to Medicare physician payment rates. This would mark the third time in the last four months Democrats have kicked the can down the road when it comes to the SGR, and the second time in as many months that the Democrats allowed the cuts to go into effect before reversing them. But unlike the last retroactive repeal, this one will come after Medicare starts processing claims with the substantial payment cut. And in a little more than two weeks, Congress will have to pass yet another bill to delay the cuts even further.

Failure to address these cuts could affect access to care for millions of seniors and disabled Americans who rely on Medicare. A physician survey found that nearly 7 in 10 physicians would no longer accept Medicare patients if the cuts go into effect—one responding physician noted “Medicare patients will essentially be standby only;” another said, “this will result in staff getting let go.”

Similarly troubling, because of the uncertainty created by the Democrats’ failure to provide anything more than a 30-day delay in the cuts, physicians do not know from one month to the next how much they will receive for treating Medicare patients. This uncertainty prevents physicians from hiring nurses and administrative staff, investing in health information technology and new medical equipment, and leaves seniors’ access to care in limbo, according to the Surgical Coalition survey. As the AMA’s Dr. Maves said, “This is the second consecutive month that Congress has recessed without preventing a payment cut, creating instability and unreliability of the Medicare program.”

By contrast, House Republicans offered a “doc fix” in November that was fully paid-for and would have provided doctors with a 2 percent update in 2010, 2011, 2012 and 2013.

As another deadline has come and gone questions remain: When will the Democrat Congress meet its obligation as stewards of the Medicare program and stop playing games with Medicare? Why must physicians operate under the specter of cuts and financial uncertainty that would decimate any other small business?

Congressional Democrats have had opportunity after opportunity to live up to their promises made to doctors across our nation, but they have failed. As a result of this failure, beginning today America’s physicians will start receiving reimbursement checks that are 21 percent lower than they were last year for providing the same Medicare service. It’s time for responsible congressional action to ensure continued access to needed physician care for all Medicare beneficiaries.

Rep. Wally Herger is Ranking Member of the Ways and Means Committee’s Health Subcommittee.