Over Protests, House Passes One-Year Extension to Medicare Payment Formula

us-capitol-building-2Despite strong protests from much of organized medicine, the U.S. House today approved – without a roll call –  a one-year extension of the current Medicare payment formula.

The Senate is expected to vote on the bill on Monday at approximately 5:00 p.m.

The “patch” legislation – as it is called – averts a 24% cut at least until April 1, 2015. It would give physicians a 0.5% raise through the end of calendar 2014, and no increase for the first three months of 2015.

The MMS, the American Medical Association and many other physician organizations bitterly opposed the bill, saying they preferred pending legislation that would completely repeal of the payment formula, known as the Sustainable Growth Rate (SGR).

The patch would also delay the implementation of ICD-10 for one full year, to October 2015. That prospect might ordinarily delight the AMA, which opposes ICD-10, but it wasn’t enough to soften the AMA’s opposition to the patch bill. Hospitals and technology groups that have heavily invested in ICD-10 criticized the delay.

This is the 17th time in 11 years that Congress has extended the current payment formula. The AMA’s opposition to this patch was rooted in its contention that it would force a fresh restart of the debate in the new Congress next year. It also protested that the patch legislation appropriates money that would have been used to pay for the repeal, making full repeal even more difficult in the next session of Congress.

The legislation fully repealing the SGR has been supported by both parties, in both chambers of Congress – a very rare phenomenon. But that bipartisan consensus crumbled over a rancorous debate over how to pay for it. Republicans wanted to fund it by delaying the Affordable Care Act’s individual mandate, while Democrats wanted to apply unused military funds. Neither party’s solution was even remotely palatable to the other.

For a brief period of time, the fervent protests of organized medicine seemed to be derailing the patch bill. After some debate on the House floor Thursday morning, there was no quorum to take a vote, and it was taken off the House calendar. But the bill returned to the podium about 90 minutes later, where it was gavelled through a voice vote in about 30 seconds (see video clip below).

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