Senate deal could mean 1-year Medicare physician payment update

Senate deal could mean 1-year Medicare physician payment update

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A recent bipartisian agreement in the Senate would use provisions in President Obama’s health care law to extend the current 2.2% Medicare physician payment update for 1 year, according toSpineAdvocacy — the North American Spine Society’s publication on government affairs.

If passed, the $19 billion 1-year fix would be funded by raising limits on overpayment of consumer tax credits. Under the Patient Protection and Affordable Care Act (PPCA), individuals can receive tax credits to purchase health insurance in state-run markets. However, individuals must pay back up to $200 of the subsidy if they misreport their income.

In addition to raising this limit, the agreement is expected to include other Medicare-related provisions such as adding inpatient drugs to the 340B Drug Pricing Program and capping therapy services.

According to the SpineAdvocacy message, the agreement is expected to face little opposition in the U.S. House of Representatives. Medicare physicians would avoid a 25% cut in reimbursements if the deal is passed before Jan. 1.

“NASS Advocacy supports the replacement of the [sustainable growth rate] with a new system that reimburses physicians based on the cost of care provided to Medicare beneficiaries,” the group wrote. “NASS Advocacy will continue work in Washington to replace the [sustainable growth rate] and urges members to contact their lawmakers to demand a permanent replacement for this unsustainable formula.”

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