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Doctors May See Payment Cut for Medicare Patients

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June 27, 2008

Doctors who treat Medicare patients will likely see a 10.6 percent cut in payments starting Tuesday. The move follows the Senate's failure to pass a Medicare bill on Thursday night. The House had earlier approved a similar measure.

Copyright © 2009 National Public Radio®. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required.

MICHELE NORRIS, host:

Medicare payments to doctors are getting cut by 10 percent. That's starting next week. No one wanted it to happen. Rather, it's the result of Congress simply not getting its act together. NPR's Julie Rovner has the story.

JULIE ROVNER: The Medicare cuts to doctors' pay are by now an annual event, the result of what just about everyone acknowledges is a glitch in the funding formula, and every year, Congress finds a way to cancel them, usually at the last minute.

This year, the script seemed to be playing out as usual. On Tuesday, the House passed a bill that would turn the 10.6-percent cut, set to take effect July 1st, into a one-percent increase. It passed overwhelmingly.

Unidentified Man: On this vote, the ayes are 355, the nays are 59, two-thirds being in the affirmative. The rules are suspended. The bill is passed without objection, the motion…

ROVNER: And that was despite efforts by House Republican leaders to get members to vote against it and a veto threat by President Bush. Republicans are torn. They don't want doctors' pay to get cut, particularly not so close to the elections this fall, but they also don't want to fix the doctor-pay problem by cutting payments to private insurance plans that serve Medicare patients. So when the House bill got to the Senate last night, Republicans like Iowa's Chuck Grassley complained that they weren't given much of a choice about how to restore payments to doctors.

Senator CHUCK GRASSLEY (Republican, Iowa): Once again, we're being told to take it or leave it.

ROVNER: Pretty much, said Senate Finance Committee Chairman Max Baucus, who'd been working unsuccessfully for weeks on a bipartisan compromise. He said the doctor-pay cut threatens care for Medicare patients.

Senator MAX BAUCUS (Democrat, Montana): Already, some providers are declining Medicare patients. That trend will accelerate, believe me. I've talked to a lot of doctors. That trend will accelerate if we don't act. We must pass this bill tonight.

ROVNER: But Senate Republicans held together and blocked the bill from moving forward. The recriminations began almost immediately, like this from Senate Democratic leader Harry Reid.

Senator HARRY REID (Democrat, Nevada): Obviously, the Republicans in the Senate have done what they feel is appropriate, and that is wipe out Medicare as we know it today.

ROVNER: Senate Republican leader Mitch McConnell tried to blame the Democrats.

Senator MITCH McCONNELL (Republican, Kentucky): The refusal of the majority to approach this issue on a bipartisan basis will lead to a presidential veto, a reduction in the reimbursement rates for doctors and expiration at the end of the week.

ROVNER: But it's clear who the doctors blame: the Republicans. Nancy Nielsen is president of the American Medical Association.

Dr. NANCY NIELSEN (President, American Medical Association): It appears that a group of senators voted to protect health insurance companies at the expense of America's seniors and disabled.

ROVNER: Nielsen says doctors have absorbed Medicare cuts before, but this cut is of a magnitude never before seen.

Dr. NIELSEN: People can't keep their doors open if their reimbursement doesn't meet their practice expenses, so this has just gotten to a tipping point.

ROVNER: It's already getting harder for new Medicare patients to find doctors. Lawmakers will try to reverse the cut when they return from their July 4th recess. Julie Rovner, NPR News, Washington.

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