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Baucus Eyes Jobs Bill as Vehicle for Blocking Physician Pay Cut, Rehabilitation Cap

By John Reichard, CQ HealthBeat Editor

Senate Finance Chairman Max Baucus, D-Mont., said Thursday that his work on developing a Democratic bill to increase jobs may include short-term fixes to prevent cuts in Medicare payments to doctors and for outpatient rehabilitation services.

Baucus said after a hearing on the Obama administration's fiscal 2011 budget proposal that a three-month doctor payment fix is "being discussed . . . quite significantly." The same is true of language that would exempt virtually all Medicare beneficiaries from a cap of $1,860 on outpatient rehabilitation services for physical and occupational therapy and for speech-language pathology services.

Majority Leader Harry Reid, D-Nev., said earlier in the day that he would like to see an initial vote on a jobs package on Feb. 8 — likely a procedural vote. Reid added that he would like to see Senate passage before members leave town Feb. 12 for the Presidents Day recess. It's unclear, however, whether any Republicans will support the measure.

"I'm working with many senators on both sides of the aisle to address jobs, and I hope to have a part of that wrapped up very soon," Baucus said.

A two-month delay of a 21 percent cut in Medicare payments to doctors expires March 1. The rehabilitation cap took effect Jan. 1.

Meanwhile, several senators are urging the Obama administration to impose an administrative delay on cutting off rehabilitation services.

"We are concerned that implementation of the Medicare outpatient therapy caps is causing undue hardship on Medicare beneficiaries, particularly for those who are recovering from a stroke or a debilitating injury such as a hip or joint fracture," Republican Charles E. Grassley of Iowa, Democrat Blanche Lincoln of Arkansas and Republican John Ensign of Nevada wrote in the letter to Health and Human Services Secretary Kathleen Sebelius.

"We have already received reports that beneficiaries with severe rehabilitation needs have already exceeded the financial caps," the senators wrote. "In fact, one national provider has reported that as of February 1, 2010, approximately 1,050 of its patients across the country will hit the caps. This number is expected to grow to more than 4,000 patients by February 28, 2010."

Congress has intervened repeatedly to keep the cap from taking effect. Lawmakers included provisions to block the cap in health care overhaul legislation, but its prospects are uncertain.

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