House Passes 'Doc Fix' for Medicare Doctors

What Is the 'Doc Fix'?

March 27, 201500:43

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/ Source: NBC News
By Maggie Fox

Congress may be mostly deadlocked, but the House of Representatives passed the so-called "doc fix" Thursday.

It rectifies one of the most annoying chores Congress has faced year in and year out for more than a decade — a flawed payment formula that has mistakenly cut the amount doctors are paid for treating Medicare patients.

It’s an overwhelmingly popular move — 392 members voted for it and only 37 said no. The bill goes to the Senate where it is likely to pass. President Barack Obama has said he has his pen ready to sign it.

“It is time to end the SGR. Let us never speak of this issue again."

Without the fix, Medicare doctors get their payments cut by 21 percent this year. Experts say the problem makes many doctors reluctant to treat Medicare patients, and advocacy groups complain that in some areas, it’s difficult for new Medicare patients to find doctors who will treat them.

What Is the 'Doc Fix'?

March 27, 201500:43

The doc fix (sustainable growth rate or SGR) problem dates back to a 1997 law based on a flawed formula for calculating Medicare payments. It linked those payments to the overall economy, but that meant it penalized doctors during a recession.

It gave doctors who treat Medicare patients modest raises for a while, but in 2002 it provided for a pay cut. Instead of fixing the formula, Congress had just kept enacting short-term solutions.

The bill passed today changes the way Medicare — the federal government’s health insurance plan for people over 65 — pays doctors.

“It is time to end the SGR. Let us never speak of this issue again,” said Texas Rep. Michael Burgess, a Republican and a physician.

“The bill will permanently replace the so-called 'doc fix' budget gimmick with a system that's more stable that rewards quality and innovation in the delivery of our health care,” House Speaker John Boehner said.

Boehner and House Democratic leader Nancy Pelosi cooked up the bill together. It would cost $214 billion over 10 years, the Congressional Budget Office says, but $73 billion can be saved via spending cuts or new revenue. Boehner says it’s cheaper than paying for one-year pay raises.

The legislation changes the way doctors get paid and aims to reward quality care.

“It will help ensure that seniors have access to their doctor, and put in place a stronger Medicare program to aid every American who are trying to care for their elderly parents,” Boehner said.

“This will be the first real entitlement reform that we've seen in nearly two decades, and that's a big win for the American people. It was a true bipartisan agreement, and I want to thank Leader Pelosi and Democrat Whip (Maryland Rep. Steny) Hoyer for their efforts in helping to put this together. I was pleased to hear the president would sign the bill, and I would urge the Senate to pass it expeditiously."

“This will be the first real entitlement reform that we've seen in nearly two decades."

Doctors’ groups welcomed the vote.

“Looking ahead, Medicare will enroll 78 million baby boomers over the next few years, making a stable, secure Medicare system absolutely essential,” said Dr. Michael Gerardi, president of the American College of Emergency Physicians.

“The ongoing uncertainty and instability caused by years of proposed cuts to the Medicare program threatens seniors’ access to medical care now and in the future.”