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'Doc Fix' Bill Gains Backing from AMA, but Short-Term Patch Does Not

By Emily Ethridge, CQ Roll Call

February 10, 2014 -- The American Medical Association (AMA) will fully support the bipartisan compromise "doc fix" bill to replace how Medicare pays physicians, but the organization is not yet offering ideas on how to pay for the measure.

In addition, the influential physicians' group is throwing cold water on the idea of a nine-month patch that's currently being floated in Congress.

AMA President Ardis Hoven announced the group's support for the replacement measure in a press call last week, calling the bipartisan deal (HR 4015, S 2000) "landmark legislation that would build a stronger Medicare program."

The group plans to ramp up its advocacy and advertising efforts to encourage lawmakers to pass the deal before the current "doc fix" patch (PL 113-67) expires March 31 and cuts current payment rates by about 24 percent under the sustainable growth rate formula.

Rich Deem, AMA's senior vice president for advocacy, said that grassroots activity is already underway, and the group will supplement it with social media and paid media activities over the next few weeks.

"Decisive congressional action is needed in the next 49 days," said Hoven.

Hoven said the group is "adamantly opposed" to another series of short-term patches, including a possible nine-month patch. Without a patch, lawmakers have a very short period of time to find an offset for the replacement bill and bring the measure to the floors of both chambers.

But Hoven said that more time would not necessarily help lawmakers reach an agreement. "Is it going to make the process any easier? Is it going to answer all the questions?" she asked of passing a short-term patch.

Lawmakers have discussed adding a nine-month payment patch to legislation that would raise the debt ceiling this month, but no decisions have been made.

Although the bipartisan, bicameral group of lawmakers reached an agreement on the policy parameters for their bill, finding agreement on how to pay for the measure is essential to its passage. Lawmakers say they are looking to find about $130 billion in offsets to pay for the replacement bill.

Several provider groups have suggested possible pay-fors, or requested to protect their own members from cuts, but the AMA is not yet giving an opinion on potential offsets.

"Right now we have no ideas what they might be considering," said Hoven. "So I think what we have to do—we have to wait until they present us with a proposal."

The negotiated deal would provide for annual payment updates for physicians of 0.5 percent over five years. Providers could also get bonuses by participating in an improved-quality program in Medicare's traditional fee-for-service system or in alternative payment models.

Hoven said the deal "is a reasonable place to start" but that the AMA would continue to look at the proposal and any suggested changes, and work for improvements.

"I trust the members of Congress to get this right. They have the ability to do it and I am confident that they will make this a priority," Hoven said.

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