Medicare pay freeze not yet final, but likely

Last-minute amendments put final action on physician payment into question.

By David Glendinning — Posted Jan. 2, 2006

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At press time, lawmakers were struggling to wrap up consideration of a budget bill that would freeze Medicare rates for physicians for one year but would avoid implementing pay-for-performance.

Both the House and the Senate passed the legislation by razor-thin margins, with Vice President Dick Cheney casting the tie-breaking vote in the upper chamber. But because Senate Democrats made several unrelated last-minute changes to the measure immediately before passage, the bill headed back to the House for final approval.

House leaders on Dec. 21, 2005, were deciding whether to reconvene before the end of the year or wait until lawmakers return for the 2006 session Jan. 31 to pass the amended bill. Absent immediate congressional action, doctors face a 4.4% Medicare cut set to take effect Jan. 1.

"Procedural issues in the Senate have prevented final action today on this critical access-to-care issue for Medicare patients," said American Medical Association President J. Edward Hill, MD. "The AMA encourages the House to act promptly ... and send this bill to the president."

While the reimbursement proposal falls short of the minimum two years of positive updates for which the AMA fought, the bill also abandons a pay-for-performance plan disliked by many doctors. Senate and House members had called for linking reimbursements to how well doctors rated on quality measures, but negotiators left the plan out of the final consensus measure.

Eventual enactment of the rate freeze still would mean that the AMA would find itself lobbying this year for long-term payment reforms to prevent Medicare rate cuts in 2007 and several years thereafter.

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