AMA balks at temporary 'fix' to Medicare physician payments

The five-year "doc fix" under consideration by House Democrats is not going over too well with the American Medical Association. 

The AMA wants a permanent fix to prevent a drastic 21.3 percent cut in Medicare reimbursement payments to physicians. In an email to members, Kenneth Hopson of the AMA's federal affairs division, said that delaying the cuts until 2015 would only lead to higher costs down the road. The AMA estimates that a permanent fix in 2015 would cost more than $500 billion; a permanent fix now would cost around $250 billion, according to the AMA ($276 billion according to Congressional Budget Office estimates).

Under that scenario, doctors actually would receive 1 to 2 percent increases in Medicare reimbursement dollars for five years before enduring a cut that could be as large as 37 percent. 

"For the last several years, Congress has chosen short-term remedies that have resulted in larger future physician payment cuts and made it much more expensive to scrap a formula that Democrats and Republicans have both said should be repealed," Hopson wrote. "Five years ago, the price tag for repealing the SGR was $49 billion." 

AMA president J. James Rohack echoed those sentiments when talking with MedPage Today. "When we're talking about physicians being concerned with a 21 percent cut, if you do a five year [temporary fix] then you're talking about a 30 percent cut--how's that going to be any better? 

"We know that if they don't have a permanent repeal as part of the solution, it's not going to solve the problem." 

Members of Congress, however, are reluctant to pull the trigger on any deal that's not paid for, and a permanent fix would almost certainly need to be a "pay-as-you-go" scenario. Senator Ron Wyden (D-Ore.) was among those who voted against including a fix in the healthcare reform bill for just that reason. 

"That was a particularly difficult vote," Wyden said, according to MedPage Today. "But I swallowed hard and voted against that measure...because $250 billion-plus wasn't paid for."

To learn more:
- read this MedPage Today piece
- check out this article from The Hill
- here's the tax extenders package that aims to prevent the cut
- here's a summary of the extenders package
- check out this ad created by the AMA calling for a permanent fix now

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