Congress Floats Physician Payment Options

In a summary of the bill, the authors explained that they didn't address the sustainable growth rate because they wanted to limit provisions to quality improvement, value-based purchasing, and health information technology. However, “sense of the Senate” language (nonbinding language that accompanied the bill) did acknowledge that the negative physician update needed to be addressed, based on the “unsustainable” nature of the SGR.

Primary care groups in June had lobbied Senate Majority Leader Bill Frist (R-Tenn.) for a pay-for-performance bill that would provide positive updates to Medicare's physician fee schedule, as well as reverse cuts that would otherwise occur under the SGR.

If any language from Grassley-Baucus is approved, “it will probably be inserted into 'end of the year must pass legislation,' along with an SGR fix,” Ms. Johnson stated. Standing alone, the bill is too risky on the Senate floor because it would provide Democrats with the opportunity to reopen the Medicare Modernization Act.

“They could introduce amendments stating that the government could negotiate prices with the pharmaceutical companies. The Republicans don't want that,” she said.