Six Month, Fully Offset “Doc Fix” Clears Senate
A few moments ago, the Senate passed by unanimous consent a six month doc fix extension. The legislation would provide a six month doc fix extension, fully paid for through 1) pension provisions included in the Thune substitute amendment Republicans voted for yesterday, 2) language clarifying the three-day payment window (a pay-for included in the Baucus substitute), and 3) a CMS-IRS data match included in both the Thune and Baucus extender packages. To be clear, the bill ONLY addresses the SGR – it does NOT include unemployment compensation, Medicaid FMAP funding, COBRA insurance subsidies, or any of the other Medicare/health provisions (e.g. Section 508 hospital extension, etc.) included in the Baucus substitute.
A summary follows below. As a reminder, because the House adjourned last night for the weekend, that body must consider the legislation early next week before the payment changes take effect. With regard to the broader extenders package, Sen. Reid did not indicate when or how the majority intends to proceed on that measure.
Medicare Physician Payment: Provides a 2.2% increase in reimbursement levels for June-November of 2010. Stipulates that the payment increase shall be disregarded for purposes of calculating SGR rates for periods after November 30, 2010. Spends $6.4 billion over five and ten years.
Hospital Payments: Prohibits Medicare from reopening or adjusting claims made by hospitals during the three days preceding a patient’s inpatient admission.
Pension Relief: Offers the same relief from pension funding obligations for companies as contained in the Republican fully paid for alternative. This relief raises $2.1 in revenue, because it will result in fewer tax-preferred contributions to pension plans and therefore more taxable income for the firms, and generates $675 million in outlay savings due to lower than expected payments by the Pension Benefit Guarantee Corporation (PBGC). Saves $2.8 billion over ten years.
IRS Data Match: Includes provisions allowing the IRS and CMS to co-ordinate data matching efforts with regard to delinquent tax debts owed by Medicare providers, and to take such information into account when releasing reimbursement payments and accepting new providers. These provisions were originally included in Section 1303 of the substitute amendment for the reconciliation bill (H.R. 4872), but were stripped out at the House Rules Committee due to Byrd rule concerns. Saves $175 million over five years and $425 million over ten, according to JCT.