Senate 'doc fix' comes too late to avoid physicians' rancor

Senators patted themselves on the back and the White House sought political cover Friday as a 21.3 percent cut to Medicare physician payments went into effect, raising the ire of doctors and seniors across the country.

The Senate passed by unanimous consent a six-month, 2.2 percent pay increase for physicians following a late-night deal between Sens. Max Baucus (D-Mont.) and Charles Grassley (R-Iowa), but with the House having already recessed for the week the deal came too late to avert the pay cut.

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"After years of band-aid patches and short-term fixes, doctors caring for the millions of seniors in Medicare are now reckoning with an unprecedented 21 percent cut to their reimbursement rates," AARP Executive Vice President Nancy LeaMond said in a statement. "This cut creates a dangerous atmosphere for seniors and their doctors, and will contribute to more doctors making the decision already made by some physicians to stop taking Medicare patients."

The American Medical Association was irate.

"This is no way to run a major health coverage program – already the instability caused by repeated short-term delays is taking its toll," American Medical Association President Cecil Wilson said in a sharply worded statement. “About one in five physicians say they have already been forced to limit the number of Medicare patients in their practice. Nearly one-third of primary care physicians have already been forced to take that action. The top two reasons physicians gave for these actions were the ongoing threat of future cuts and the fact that Medicare payment rates were already too low.”

Senators, understandably, preferred to focus Friday on the accomplishment rather than the blown deadlines.

Senate Minority Leader Mitch McConnell (R-Ky.) said the bill "achieves a goal that both sides wanted to achieve."

"And we've done it," McConnell added, "without adding to the deficit." Added Senate Majority Leader Harry Reid (D-Nev.): "I'm glad we were able to work this out."

The cuts were supposed to kick in June 1, but the agency that oversees Medicare twice asked claims handlers to hold off on processing physicians' payments. The goal was to allow Congress enough time to avert the cuts, but on Friday the agency told contractors to start paying claims going back to June 1 with the pay cut in place. The "doc fix" passed by the Senate is retroactive to June 1, so if it makes it into law physicians would get a second check.

For its part, the White House sought to distance itself from the fiasco on Friday, pointing the finger squarely at Republicans.

"As of today, doctors are going to say that their Medicare payments ... are jeopardizing the ability of them to see seniors ... (because) a 21 percent cut is going into effect," Vice President Joe Biden said shortly before the provision passed. "This time, the other party decided that they weren't going to participate in trying to deal with this straight up. And so I urge -- I urge my colleagues on the Republican side to put politics aside for a minute here ... and let the United States Senate vote on behalf of seniors in this country, allowing their doctors to get paid fairly."

Even with passage in the Senate, questions remain about whether the $6.5 billion "doc fix" will even survive in the House, which last month passed its own 19-month fix. The Senate version is paid for by a $4.2 billion hospital payment provision and a Republican provision that offers companies relief from pension funding obligations and reduces the deficit by $2.8 billion.

A hospital source tells The Hill that the industry dislikes the payment provision, which has already passed the House, but won't fight it.

"We're not going to drag down the (doc fix) on this," the source said. "We just don't want to be treated like a piggy bank."