Doc Fix Deal Elusive with Time Running Out

“Doc Fix” Deal Proves Elusive in Year-end Legislation — Democrats and Republicans in congress are predictably having trouble making a deal to change the sustainable growth rate (aka SGR or doc fix) halting a 27% reimbursement cut to physicians serving Medicare patients beginning next year. An extension of unemployment insurance and the Social Security payroll tax exemption is also considered must pass legislation and is being included in the SGR talks as well. 

Republicans are insisting any changes to current legislation be “paid for” and are suggesting offsets such as increasing premiums for wealthy individuals on Medicare in addition to other Affordable Care Act and health care related cuts.  Democrats are insisting the unemployment insurance extension and  extension of the Social Security payroll tax exemption, stemming from the deal extending tax cuts for wealthy individuals during the lame duck congressional session following the 2010 elections. They have proposed paying for the tax exemption, unemployment insurance and the SGR, by applying projected savings from decreased costs associated with the wars in Iraq and Afghanistan.  Both sides seem to understand that a final deal is necessary to fix the SGR, but considerable political haggling remains before a final deal will be hammered out prior to heading home for the holidays.

House GOP Bill Details HERE  Senate Democratic Bill Details HERE

CMS Announces New Details on Round II DMEPOS Competitive Bidding — The Centers for Medicare and Medicaid Services (CMS) recently announced operational details for their much maligned competitive bidding program for durable medical equipment.  The rollout of the program has created problems due to a lack of transparency in the bid process, access to quality equipment and general confusion among beneficiaries in competitively bid areas across the country.  The recent release laid out a timeline for bidding in an additional 91 metropolitan areas included in Round II competitive bidding.  The release also detailed provider education availabilities and minor changes to certain products included in the the program moving forward.  Just as a reminder, orthotics and prosthetics, including off the shelf orthotics, are not included in competitive bidding for Round II.  For more information on Round II competitive bidding for Medicare DMEPOS, click HERE.  

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