What exactly is Doctor's Fix?

[auburnO5]

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I've tried searching for this on here, googling, etc. and couldn't come up with anything good. What exactly is it, was it in the healthcare bill? The reconciliation bill?

 

[DrYoda]

The "doc fix" is the repealing of the sustainable growth rate (SGR) formula, which is the flawed medicare formula that is calling for the 21% across the board reimbursement cuts to physicians.

No it was not in the bill.

 

[auburnO5]

The "doc fix" is the repealing of the sustainable growth rate (SGR) formula, which is the flawed medicare formula that is calling for the 21% across the board reimbursement cuts to physicians.

No it was not in the bill.

Thanks, will it have to be voted on by congress? Do you know if it is likely to get through?

 

[DrYoda]

Thanks, will it have to be voted on by congress? Do you know if it is likely to get through?

They do have to vote on it. A temporary fix was rolled in with that job bill that they failed to pass. So the 21% cut is happening at least until they get back from vacation when they claim they will retroactively fix it.

So far there is no long term fix that has emerged, they just keeping kicking the problem down the road with temporary fixes.

 

[i love cookies]

This is actually a really important issue in healthcare, arguably more important than our current reform bill. As I remember it, SGR seeks to incrementally cut Medicare reimbursement to physicians by 40% over ten years. That's a lot of money. Every year that there is a scheduled cut, Congress has to go and find a way to avoid the cut while staying budget neutral. Back in 2008, the Medicare Improvement for Patients and Physicians Act was passed to reconcile a 10.9% cut. Congress found most of the funding through cuts in Medicare Part C. That bill also fundamentally changed many other reimbursement programs, DME, and e-prescribing.

 

[TheFlashMD]

The "doc fix" is the repealing of the sustainable growth rate (SGR) formula, which is the flawed medicare formula that is calling for the 21% across the board reimbursement cuts to physicians.

No it was not in the bill.

To add to what Yoda said:

In 1998, the SGR formula was created to tie healthcosts to regular inflation. If healthcare costs rise above inflation, Medicare reimbursements would be slashed to control spending. Since 1998, medical technology has boomed and many new treatments previously not available caused healthcare costs to rise outpacing inflation. Since around 2002, the SGR mandated cuts to reimbursements, but Congress for the last 8 years has used short-term 'fixes' to prevent these cuts.

In exchange for support of the HCR bill, the AMA has lobbied for a long-term fix for the SGR formula. Congressional leaders wanted to pass the 'doctor fix' outside of the HCR bill because, if included, the HCR would not be deficit neutral. This attempt failed last fall, and another attempt to fix the problem was also stripped from the jobs bill in February.

 

[stromijj]

i to was interested in this but have not been able to find much info on it. do you ever see it come into existance or just something that gets talked about but never materializes?

 

[futureboy]

In exchange for support of the HCR bill, the AMA has lobbied for a long-term fix for the SGR formula. Congressional leaders wanted to pass the 'doctor fix' outside of the HCR bill because, if included, the HCR would not be deficit neutral.

Yes, you are 100% correct. Congress left the doctor fix out of the healthcare bill so they could falsely claim that the bill would reduce the deficit (or not increase it).

 

[FlowRate]

Self-medication.