By Erin Kelly, USA TODAY
9:46 p.m. EDT April 14, 2015 – WASHINGTON – The Senate passed a bipartisan bill Tuesday to prevent a 21% cut in payments to doctors who treat Medicare patients just hours before that cut was to take effect.
President Obama is expected to quickly sign the bill into law.
The 92-8 vote came just in time to stop doctors from receiving dramatically smaller checks. The current funding formula expired on April 1. However, the Centers for Medicare and Medicaid Services said that it takes a minimum of 14 days to pay claims from doctors, giving senators until midnight Tuesday to act before checks went out.
Sen. Rand Paul, R-Ky., one of three GOP senators who have announced that they are running for president, voted to approve the bill. The other two presidential hopefuls, Sens. Ted Cruz of Texas and Marco Rubio of Florida, voted against it.
Senate Majority Leader Mitch McConnell said the bill would “ensure seniors on Medicare don’t lose access to their doctors.” Many doctors would have been reluctant to accept Medicare patients if the federal payments to physicians had dropped 21%, the bill’s supporters said.
The bill would repeal the current Medicare payment formula for doctors and replace it with one that would increase payments to doctors by one-half of 1% every year through 2019. After that, doctors would receive bonuses or penalties depending on performance scores from the government. Their scores would be based on the value of the care they provide rather than on the volume of patients they see.
Medicare recipients with incomes of more than $85,000 a year would be required to pay higher Medicare Part B premiums starting in 2018.
The legislation would end the annual scramble by lawmakers to pass a temporary patch to keep the payments from plummeting. Congress has been struggling with what both sides call a “flawed formula” since lawmakers enacted it in 1997.
“It’s a solution to a broken Medicare payment system that had vexed congressional leaders of both parties for years,” McConnell said. “It would mean an end to the annual exercise of Congress passing a temporary ‘fix’ to the problem one year and then coming right up to the very same cliff the next year, without actually solving the underlying problem.”
Oregon Sen. Ron Wyden, the senior Democrat on the Finance Committee, said the bill gives Congress a chance to “stop patching this leaky boat.”
“We have a chance for seniors and their providers to cross the victory line and be better off and have a better system for all Americans,” Wyden said.
The non-partisan Congressional Budget Office estimated that the bill would increase the deficit by $141 billion over 11 years. But the CBO also said the bill spends $900 million less than if Congress simply froze Medicare payment rates for doctors over that same period.
The House overwhelmingly passed the “doc fix” bill by a vote of 392-37 on March 26 before leaving town for a two-week recess. However, Senate leaders could not get a consensus to approve the legislation before the break. Conservative budget hawks objected to the fact that the bill would increase the deficit while liberals wanted it to extend the Children’s Health Insurance Program for four years instead of the two years specified in the bill. The program provides medical coverage for families that are struggling financially but aren’t poor enough to be on Medicaid.
With only about two hours left before the cut in doctors’ reimbursement payments would take effect, the Senate finally acted late Tuesday, their first full day back from recess.
Senators defeated three amendments by Republicans, including one by Utah Sen. Mike Lee that would have required Congress to cut the federal budget to offset the cost of the bill. They also rejected three amendments by Democrats, including one by Colorado Sen. Michael Bennet that would have extended the children’s health program for four years instead of two.
McConnell told reporters before the vote that he hoped all the amendments would fail so that the bill passed by the Senate would be the same as the legislation passed by the House and would not need any more votes before it could be signed into law by the president.
The White House came out in support of the House bill the day before it passed. The House legislation was negotiated by Speaker John Boehner, R-Ohio, and Minority Leader Nancy Pelosi, D-Calif.
“This can serve as a template of how things should work around here,” Sen. Orrin Hatch, R-Utah, said of the rare bipartisan agreement.