On February 17, 2012, the Conference  Report on H.R. 3630, the "Temporary Payroll Tax Cut Continuation Act of 2011" was adopted by a vote of 293-132 in the U.S. House of Representatives and 60-36 in the U.S. Senate.  Included among other issues in H.R. 3630 is a Medicare Sustainable Growth Rate (SGR) patch, or “doc fix.”  The adoption of this Conference Report averts the 27.4 percent SGR cuts previously scheduled to go into effect on March 1, 2012 and extends current Medicare payment rates through January 1, 2013.  The Conference Report now goes to President Obama, who is expected to sign H.R. 3630 into law. 

In H.R. 3630, the “doc fix” provision is paid for with several health care-related budget offsets including reductions of $6.9 billion in subsidies to hospitals for “bad debt” payments (Medicare patients who fail to pay premiums and copays), $5 billion from the health care reform law, the Patient Protection and Affordable Care Act’s (PPACA) Prevention and Public Health Fund (a wellness and disease prevention fund) , $4.1 billion from disproportionate share hospitals (hospitals with significant numbers of patients without insurance), $2.7 billion from clinical laboratory tests, and $2.5 billion from funds PPACA allocated to Louisiana’s Medicaid budget. 

This 10 month fix will leave the issue of a pending 32 percent cut in January 1, 2013 to the lame duck Congress—a reference to the period of time between the 2012 elections and swearing-in of the new 113th Session of Congress.  This lame duck session is expected to be very busy as several key issues’ deadlines approach, including the SGR, unemployment benefits, the expiration of the so-called Bush tax cuts and efforts to halt a round of across-the-board spending cuts mandated by the Budget Control Act of 2011.

Of note in H.R. 3630 is language in the adopted law requiring the Department of Health and Human Services (HHS) and the Government Accountability Office (GAO) to conduct studies on new methodologies for Medicare payment.  The GAO is the entity that released the report titled “Medicare and Private Payment Differences for Anesthesia Services,” which indicated that the average Medicare payments for anesthesia services represented only 33 percent of the prevailing commercial insurance payments for the same service.  As part of discussions about new payment methodologies at GAO and HHS, ASA will continue to advance new models of care such as the Surgical Home™ model.

ASA will continue advocacy efforts for a full repeal and replacement of the flawed SGR payment model.

To view the bill, please click here.
To view the House vote, please click here.
To view the Senate vote, please click here.
To view the House Democratic Ways & Means Summary of H.R. 3630, click here.
To view the House Republican Ways & Means Summary of Health Care Provisions of H.R. 3630, click here.