Payment Band Aid Sticks for Six

As most of you already know, there is news from Capitol Hill — not great news, but news. Before they recessed for the holidays, the Senate and House voted to approve a six-month Medicare payment update and extension of incentive funds for PQRI. As a result of CV societies’ collective efforts, the legislation does not include imaging cuts or policy. The fix replaces the scheduled 10 percent cut with a .5 percent update from Jan. 1 to June 30, 2008. The legislation does not pay down the cost of the update, making the cost of future fixes even higher. 

They got most of the money by borrowing from the Medicare Trust Fund, which is really “funny money” supposedly allocated for future boomer Medicare costs. They didn’t tap Medicare Advantage insurers so that Mr. Bush will sign the big domestic spending bill in which this fix was embedded.  The PQRI program was not terminated, so theoretically a 1.5% payment for participation continues for the first six months of 2008.

So, what’s next? The ACC will continue to fight the payment battle in the hopes of achieving a long-term solution rather than perpetuating the series of short-term band aids. The College sent a letter to Senate Finance Committee Chair Max Baucus (D-Mont.) and Ranking Member Charles Grassley (R-Iowa) expressing disappointment in the temporary nature of the fix.

Congress fully agrees with us that the current system is unsustainable, and they frankly hate this SGR formula mess as much as we do. But they can’t agree on how to fund our way out of it. It is critical that we together craft a long-term strategy. As irritating as this is, it is far better to delay the cuts for now, and go after more help during the election year when Congress doesn’t want to have embarrassing battles that could alarm patients — aka voters. We don’t think any real long-term reform in payment fairness will occur until 2009. But something will have to happen then. We’ll be ready.


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