Sen. Baucus Outlines Plan That Would Delay Medicare Physician Fee Cut for 18 Months

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At a meeting with physicians on Friday, Senate Finance Committee Chair Max Baucus (D-Mont.) outlined a package of Medicare legislation that would delay for 18 months a 10% Medicare physician payment cut that is scheduled to take effect July 1, CQ Today reports. The measure would prevent the cuts until 2010 and could also increase payments by 1.1%. The bill would cost about $8.4 billion over five years; halting the cuts without the increase would cost about $8 billion.

The measure would use so-called “balloon financing,” which means physicians would face a payment cut of 21% in 2010 (Armstrong, CQ Today, 4/11). Baucus said that he would not allow the large pay cut to take place in 2010 and that next year he would address the Medicare physician pay funding mechanism more broadly.

Baucus also said that he wants to increase Medicare payments to primary care physicians and link reimbursements to quality of care as provisions of the Medicare package, which he plans to have on the Senate floor by mid-May, CongressDaily reports (Johnson, CongressDaily, 4/11). The Medicare Payment Advisory Commission has expressed concern that Medicare and the nation generally will face a shortage of internists and family practitioners. MedPAC analysts said that a pay increase would help bolster the number of PCPs, who receive relatively lower salaries than specialists, causing fewer medical students to choose primary care (Reichard, CQ HealthBeat, 4/11).

Lawmakers also are considering the Physician Shortage Elimination Act, which would provide scholarships to medical students and expand residency training programs. State medical societies say that by 2020 the nation could face a shortage of up to 200,000 physicians as the population is expected to grow by 24% and the number of baby boomers who are eligible for Medicare increases (Hotakainen, McClatchy/Orlando Sentinel, 4/13).

Other Provisions
Baucus on Friday also outlined a few other provisions he would like to appear in the bill. One would give physicians incentives for using electronic prescribing and other types of electronic health records. Another would increase or expand the physician quality reporting initiative, which increases payments for reporting quality data (CQ Today, 4/11). Baucus also wants to expand an HHS pilot project that promotes “medical homes” where a physician practices coordinate care for beneficiaries in underserved areas. Baucus also said that although there were several Medicaid provisions in last year’s Medicare bill, this time he is unsure whether Medicaid will be addressed (CongressDaily, 4/11).

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