The fee fix — along with the unemployment measure and an extension for additional Medicaid funding for the states — was part of a bill passed by the House in late May but defeated last week in the Senate in two separate versions because it would have added to the federal deficit.
On Friday, the Senate pulled out the fee fix from the defeated bill and passed it separately, using savings from other federal programs to make it deficit-neutral so that GOP senators would vote for it.
The fee fix costs $6.4 billion, much less than the $40 billion unemployment measure and the $24 billion Medicaid extension, which the Senate left in limbo. Ms. Pelosi called the new Senate bill “a great disappointment,” adding: “I see no reason to pass this inadequate bill until we see jobs legislation coming out of the Senate,” she stated.
Also on Friday, CMS directed Medicare claims processors to begin applying the 21.3 percent physician fee cut to all bills for services beginning June 1. This means practices will start to see payments for services delivered in the past two weeks, which were being withheld by CMS to give the Senate more time to pass the fee fix. But until the House passes the new bill, the 21.3 percent fee cut will start to be applied to all June claims.
“This is no way to run a major health coverage program,” said AMA President Cecil Wilson in reaction to implementation of the fee cut. The AMA has warned that physicians would limit Medicare patients or even drop out of the program because of the instability of Medicare payments.
The Senate-passed fee fix would replace the fee cut with a 2.2 percent fee increase that lasts through Nov. 30. It was offset by a $4.2 billion hospital payment provision and a provision that offered companies relief from pension funding obligations.
This made it acceptable to Republicans who had opposed to the earlier bills they added to the deficit. “We’ve done it without adding to the deficit, and I think that is something both sides can feel good about,” said Minority Leader Sen. Mitch McConnell (R-Ky.) after the vote.
Read Politico’s report on the Medicare fee fix.
