Advocacy

Congress Fails to Avert Physician Payment Cuts

Endocrine Insider
June 27, 2008

Medicare Physician Payments
Legislation to prevent impending Medicare physician payment cuts from taking effect has failed to make it through the Senate this week. In the absence of a bill passed by both houses of Congress, payments will fall 10.6 percent on July 1, 2008, and by 5 percent more on January 1, 2009.

On June 24, the House passed, by a veto-proof margin, The "Medicare Improvements for Patients and Providers Act of 2008," (H.R. 6331), introduced by Ways and Means Committee Chair Charles Rangel (D-NY) and Energy and Commerce Committee Chair John Dingell (D-MI), aimed to block the impending cuts and provide a 0.5 percent increase for payments starting July 1, 2008, and another 1.1 percent in 2009. The legislation includes these provisions:

  • Incentives for physicians to use an e-prescribing system in 2009 and 2010, with a requirement that they use it by 2011. For those failing to use an e-prescribing system in 2011, payments will be reduced up to 2 percent.    Excluded are those who write prescriptions infrequently or are under financial hardship.
  • Extension of the Physician Quality Reporting Initiative through 2010 and a bonus increase from 1.5 percent to 2 percent for 2009 and 2010.
  • Increased funding for the Medical Home Demonstration Project established in 2006 and permission for the HHS Secretary to expand the scope of the demonstration if certain cost savings and/or quality targets are met.

On Thursday, June 26, the Senate took up H.R. 6331. Senate Majority Leader Harry Reid (D-NV) invoked cloture in an attempt to send the bill up for a vote in the Senate without floor debate. However, the Senate failed to secure cloture, and all indications are that the bill will not be taken up again before the July 4 recess. As a result, the 10.6 percent pay cut that the physician community has been working to avert will go into effect July 1.

Sen. Reid stated that while the pay cut will initially go through, legislation to fix physician reimbursements will be considered soon after Congress returns in July. It remains to be seen what changes may be made to the legislation to secure support from both Republicans and Democrats. One option may be the compromise legislation Sen. Max Baucus (D-MT), chair of the Senate Finance Committee, and Sen. Charles Grassley (R-IA), ranking member of the committee, have developed. Details of the legislation are unavailable at this time, but it is believed that the compromise blocks the pay cut for 18 months by giving physicians a 0.5 percent Medicare payment increase in 2008 and freezing payments in 2009. 

Write to Congress by clicking on the following link and tell them to vote to stop the cuts:  http://www.endo-society.org/advocacy/capwiz.cfm. 

DXA Payments
In addition to its efforts to block the payment cuts, The Endocrine Society, along with a coalition of Sister Societies and other concerned organizations, worked with Sen. Ken Salazar (D-CO) and Rep. Shelley Berkley (D-NV) to include a provision in the Senate and House packages that would halt the cuts to physician payments for dual energy x-ray absorptiometry (DXA) that took effect on January 1, 2007. In November 2007, Rep. Berkley introduced the "Medicare Fracture Prevention and Osteoporosis Testing Act" (H.R. 4206) in support of DXA and vertebral fracture assessment (VFA) services, and Sens. Salazar and Olympia Snowe (R-ME) introduced a companion Senate bill (S. 2702) in February 2008. These bills would overturn the drastic cuts to Medicare reimbursement for DXA and VFA tests already being applied. The cuts will reduce DXA service payments from $140 in 2006 to $50 in 2010, making it difficult for endocrinologists and other providers to continue offering their patients DXA and VFA services in a non-hospital setting.  Unfortunately, in an effort to keep the cost of the Medicare package down, members of Congress were unable to address the DXA payment cuts in the current packages.  The freestanding bills remain active in both the House and Senate, and the Society will continue to work with the coalition towards passage of these bills.