Congress recently passed the Medicare Access and CHIP Reauthorization Act, also known as the permanent “doc fix” bill. The bill passed the House of Representatives 392-37 and the Senate 92-8, with strong bipartisan support. The White House has announced President Obama’s intent to sign the bill into law.
Those who voted in favor of the bill felt it was necessary to permanently replace the current Medicare physician payment formula. In 1997, Congress passed a formula known as the sustainable growth rate (SGR) formula, which unexpectedly dictated regular pay cuts for doctors. In 2003, many in Congress began to fear that the continuation of these pay cuts would prompt facilities to leave the Medicare program, reducing seniors’ access to care. That was the first year Congress passed a temporary doc fix bill to prevent these cuts from going into effect, and has passed 16 others since then. Many in Congress agreed with Medicare doctors that they needed to permanently repeal the SGR formula because the uncertainty around doctors’ payment rates was economically unhealthy. However, individuals within Congress disagreed on how to offset the cost of replacing the SGR formula.
We are pleased to report that no cuts to dialysis funding are included in the bill. This time around, Congress chose not to offset the entire cost. However, the bill would require wealthy seniors to pay more for their Medicare outpatient and prescription drug coverage, and restrict Medigap plans from being used to cover the Part B deductibles (currently $147). These changes will only apply to future Medicare beneficiaries and will not affect current dialysis patients enrolled in Medicare.