American Society of Hematology

One-Year 'Doc Fix' Included in Fiscal Cliff Package

Published on: January 02, 2013

The fiscal cliff legislation passed by the Congress on January 1 incudes a one-year payment patch for physicians who treat Medicare patients. The legislation also defers sequestration cuts for two months that included an additional 2 percent cut in Medicare payments.

The deal (HR 8), negotiated by Vice President Joe Biden and Senate Republican Leader Mitch McConnell of Kentucky, would block scheduled 27 percent payment cuts to Medicare physicians that were scheduled to start Jan. 1, and keep rates frozen at current levels for one year.

For the past decade, Congress has dealt with scheduled payment cuts to Medicare physicians by enacting a series of short-term patches known as a "doc fix." In recent years, lawmakers have insisted the cost of the patch be offset through other spending cuts.

The one-year patch estimated to cost the government $25 billion, will be paid for by a variety of offsets related to health care. Fortunately, proposals to eliminate the increase in Medicaid payments for primary care services that will also benefit some hematologists and funds for the prevention provisions included in the Affordable Care Act were not adopted. Payments for advanced imaging services, however, will be reduced based on a change in assumptions regarding the utilization of equipment. Other offsets included extending the statute of limitations from three to five years for recoupment of overpayments and elimination of unobligated funds for health insurance co-ops authorized by the Affordable Care Act. Existing obligations to health insurance co-ops will be honored.

ASH leadership thanks all who have participated in grassroots efforts over the past months and years that have contributed to this outcome.

Physician practices would have been devastated if these cuts were not averted. ASH encourages everyone in the practice community to join with the Society in continuing to pressure Congress to permanently repeal the SGR.

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