Congress (Finally) Approves ‘Doc Fix’

Lawmakers last week did what they have not been able to do for more than 17 years. They approved a plan to prevent a large cut in payments to doctors who treat Medicare and TRICARE patients. President Barack Obama signed the bill into law Thursday.

The law repairs a flaw in a formula enacted by Congress in 1997 to slow the growth of Medicare’s cost by limiting reimbursements to physicians. It also applied to TRICARE payments. But the formula shortchanged doctors and gave them incentive to stop seeing those patients. Each year, then, Congress has provided a one-year “doc fix,” as it became called.

NGAUS has pushed Congress for years to find a more permanent solution to give physicians and patients a sense of security.

“Congress has finally given this problem the attention it has deserved for years,” said retired Col. Pete Duffy, the NGAUS legislative director. “We are happy to see the bipartisan support for this fix on Capitol Hill. Our members who use TRICARE can rest easy now.”

Doctors faced a cut of 21 percent in reimbursements last week if the law had not been approved.

The new law repeals the old Medicare formula and replaces it with one that provides an increase of .5 percent on payments to doctors until 2019. It then pays on the basis of performance, either offering bonuses or penalties depending on the government scorecard.

The performance will be based on the quality of care, which the president mentioned when he signed the bill, saying, it “starts encouraging payments based on quality, not the number of tests that are provided or the number of procedures that are applied, but whether or not people actually start feeling better.”