Many people thought 2010 would be the year of the permanent Medicare payment fix, that health reform would bring along the end of the flawed sustainable growth rate (SGR) formula. Nope, that just won't be so, says a top industry lobbyist. "If I was a betting man, no, not going to happen," he told me in an off-the-record conversation last week. I can't disclose his name, his organization or even what type of group he represents, but I can tell you he's been sitting in all those secret, behind-closed-doors discussions with top Democrats that you've been hearing about on cable news shows. I wouldn't bet against his bet.
Remember: The SGR formula is responsible for projecting year after year of cuts to physician payments under Medicare, including the 21% cut that's currently casting a shadow over your Medicare revenue.
The case for a permanent fix this year was strengthened by public statements from Democratic leaders, including Sens. Harry Reid (D-Nev.) and Max Baucus (D-Mont.), as well as the White House. But the battle for health reform legislation, which was widely assailed for its high price tag, changed the equation, the lobbyist says. "[Republicans] lumped the doc fix together with reform, and now it's very tough to pass a permanent doc fix worth $240 billion without them attacking it as even more spending tied to the reform bill," the lobbyist says.
This happens to echo some remarks made by Rep. Michael Burgess (R-Texas) in my interview with him last week. Democrats weren't acting on a permanent SGR fix right away because they want enough time to have elapsed between passage of the reform bill and action on SGR, so the two won't appear related, Burgess said.
Stay tuned for the next issue of Part B News, where I'll include more commentary on the fate of a permanent "doc" fix and what you can expect in terms of more temporary pay-fix "patches" like the ones you've grown used to seeing.