Congress Passes Doc Fix
BY LAUREN UZDIENSKI, DECEMBER 27, 2011
On Friday, Congress passed a bill that would delay a scheduled 27% cut in CMS reimbursement rates. These cuts have been mounting for years, as Congress has postponed each annual pay reduction with a legislative patch known as the "doc fix."
The origin of the pay cuts is with the sustainable growth rate (SGR), a formula implemented in 1997 to align physician pay with overall economic growth. Doc-fix legislation has been passed like clockwork since the early 2000s, though there has been some concern that the process is becoming less predictable. Last year, there were two incidents where the legislation was allowed to expire for a number of days (CMS delayed the processing of claims during those periods, giving Congress time to act), and the fate of the latest doc fix, included in a controversial payroll tax bill, was a question mark just days before the bill was ultimately passed. Eliminating the SGR and developing a new method to calculate a sustainable physician pay schedule has long been suggested, but the process would be complex and expensive (the Washington Post estimates $300 billion).
For now, Congress is likely to continue to patch the pay cuts, despite pressure to find a longer-term solution to the pay formula. The current fix expires on February 29, 2012, so this issue will not lie dormant for long.
