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Lawmakers offer dueling approaches on fixing doc pay

Dueling legislative approaches to overhaul the Medicare physician payment  formula emerged this week.

The new movement on the stubborn problem comes  as the Congressional Budget Office revised the 10-year cost of fixing it down by  more than 40%, to $138 billion from $245 billion, based on lower spending on  physician services in recent years.

There are some general similarities  but also critical differences between an approach contained in bipartisan  legislation introduced Wednesday and a Republican bill expected in the coming  months.

Both a bill introduced Wednesday by Rep. Allyson Schwartz (D-Pa.)  and a bill expected from Ways and Means Health subcommittee Chairman Kevin Brady  (R-Texas) would replace the sustainable growth-rate formula with temporary  increases while replacement methodologies were devised.

But the bills  differ on important points, including whether federal officials or physician  groups would take the lead in developing new payment systems and the degree to  which fee-for-service payments would be eliminated.

Schwartz’s  bill (PDF) would mostly unravel the fee-for-service system by requiring  physicians to adopt one of several replacement models that the CMS would test  and approve over five years. Physicians who did not do so would face successive  payment cuts, although a small number of physicians could remain in a modified  fee-for-service system if they met certain quality benchmarks or were near  retirement.

But that small fee-for-service allowance was not enough to  garner the support of the biggest physician advocacy groups such as the American  Medical Association, which wanted a larger allowance for rural physicians to  continue to use the traditional payment system, according to Capitol Hill  sources.

Read more: Dueling approaches emerge on fixing doc pay | Modern Healthcare http://www.modernhealthcare.com/article/20130206/NEWS/302069949#ixzz2KiuNyUb7
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