House Vote Blocks Medicare Payment Cut For One More Year

Once again displaying the brinkmanship that was its hallmark, the 112th Congress finally passed legislation Tuesday night to avert the “fiscal cliff” for at least two more months, and blocked a devastating 27 percent cut in physician Medicare fees for at least another year.

The Senate overwhelmingly (89-8) passed a compromise brokered by Vice President Biden and Senate Minority Leader McConnell at 2 a.m. on New Year’s Day. The House followed suit precisely 21 hours later, passing the measure 257-167.

But that comfortable margin belies the fact that for several hours on New Years’ Day, the bill seemed doomed. Republican leaders, unhappy over what they said were insufficient spending cuts, were threatening to amend the bill and send it back to the Senate to a certain death. But after determining that this tactic might not even pass their own chamber, they scheduled a straight up or down vote for the end of the evening, with no amendments.

The Medicare patch was paid for by cutting spending in other Medicare accounts. These cuts included:

  • $10.5 billion by adjusting some hospital coding rules
  • $4.9 billion in payments for end-stage renal disease care
  • $4.2 billion in payments to Disproportionate Share Hospitals (DSH)

Full details of the Medicare extensions and cuts are available here.

Here’s the AMA’s statement on the vote:

This patch temporarily alleviates the problem, but Congress’ work is not complete; it has simply delayed this massive, unsustainable cut for one year. Over the next months, it must act to eliminate this ongoing problem once and for all.

This last-minute action on the part of Congress is a clear example of how the Medicare program is increasingly unreliable for physicians and patients. This instability stalls progress in moving Medicare toward new health care delivery models that can improve value for patients through better care coordination.

Physicians want to work with Congress to move past this ongoing crisis and toward a Medicare program that ensures access to care and the best health outcomes for patients and a stable, rewarding practice environment for physicians.

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