Senate rejects proposal to erase big cut in Medicare physician payments

Radiologists and other physicians are feeling the frustration of losing a key Senate vote that would have erased an impending 21% Medicare rate cut and killed the sustainable growth rate policy that has forced Congress to delay other planned rate reductions for each of the past seven years.

The inability to find a financial offset to pay for the accumulated $245 billion cost of those delays was cited as the main reason a key procedural measure failed. The measure received 53 yes votes, which was seven votes short of the supermajority needed to close down floor debate. If Congress does not act by Dec. 31, physicians will face a massive 21% cut in the payment rate for Medicare Part B services beginning the next year.

"It's regrettable," said Cynthia R. Moran, assistant executive director for government relations and economic policy at the American College of Radiology. "[The SGR] is a flawed policy that has been allowed to fester by both Republican and Democratic White Houses and Congresses."

S 1776, introduced by Sen. Debbie Stabenow (D-MI), would have permanently eliminated SGR rate cuts and paid off the bill over 10 years, but it was doomed by bipartisan concerns about its impact on the growing federal deficit. All 40 Republicans and 13 Democrats voted Oct. 21 against a motion to end debate about the measure on the Senate floor.

The Senate missed an opportunity to respond to the actual costs of providing Medicare services and, by choosing to address this issue annually, is ultimately spending more money, said SNM president Dr. Michael M. Graham.

"SNM is disappointed that Congress did not take action on this issue at this time," he said.

The ACR and other physician groups are frustrated that Congress is moving forward with healthcare reform without seriously addressing SGR policy and medical legal liability, both issues at the top of their legislative agendas, according to Moran. These important problems are bogging down the U.S. healthcare system, she said.

"When all is said and done, we are going to have to ask, is Congress going in the right direction to deal with systemic healthcare reform?" she said.

The SGR issue will soon be resurrected. A bill to fix the dilemma is pending in the House of Representatives, and the Senate Finance Committee has added language to an unrelated bill to give Congress another year to work out a solution.

Recent political maneuvering, however, suggests that lawmakers won't seriously revisit the SGR issue until after they figure out how to pay for the larger healthcare reform bill. As in previous years, last-minute legislation may roll out of Congress late in December.

"I wouldn't be surprised if deliberations don't go until next year on all of these issues," Moran said. "But that really means they are going to have something ready to go prior to December 31, otherwise those cuts go into effect January 1."