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    Sunday, April 28, 2024

    Finally a fix to stop annual threat to doctors of Medicare rate cuts

    It appears Congress may be ready to permanently fix a perennial Medicare funding problem that has threatened to drive many doctors from the profession. This comes after 17 temporary fixes over as many years.

    We are amazed. The House of Representatives has done its part. Now the Senate has to close the deal.

    Congress has long known that Medicare reimbursements do not meet a physician’s cost of providing care. The problem dates back to Medicare cost-reform legislation passed in 1997 that included the so-called SGR, or “Sustainable Growth Rate.”

    The SGR links physician reimbursement to the Gross Domestic Product, not rapidly rising health care costs. That is a problem foisted on the doctors. Simply stated, Medicare reimbursements do not meet the cost of providing care, never mind giving doctors a profit.

    The problem has been widely debated since 2002, when the SGR formula resulted in a 4.8 percent cut in doctors’ reimbursement rates. Rather than fix the formula, Congress has repeatedly passed stopgap measures to keep the cuts from taking effect.

    On these editorial pages, we have repeatedly pointed to this as a problem needing genuine repair.

    Last month a bill that proposes to do just that — negotiated by Speaker John Boehner and Minority Leader Nancy Pelosi, of all people — passed the House of Representatives 392-37. It would eliminate the SGR and the threatened cuts in reimbursement rates to doctors. It establishes a payment system based on the quality and continuum of care, rather than the number of services and tests provided, as has been the case.

    To pay for adequately funding medical services, the bill raises Medicare premiums for medical and drug coverage by $82 monthly for the wealthy, starting in 2018. Individuals making $133,500 or more or couples making double that would see a premium increase. They can afford it.

    Unfortunately, the Senate is adding unnecessary drama to the equation. It is on recess and not scheduled to return until April 13. Doctors face a 21 percent cut April 15 under the existing SGR formula.

    Another temporary extension may be needed to give the Senate time to get back and evaluate the legislation. But after due diligence, and potentially a few tweaks, we urge the Senate to pass the legislation.

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