CMS: House Medicare ‘doc fix’ not long-term solution

The chief actuary for the Centers for Medicare and Medicaid Services is warning that the House’s recently passed bill on the “doc fix” will not be the final step to resolving a nearly 20-year-old problem (Source: “Medicare agency: House bill not quite a 'doc fix',” The Hill, April 10, 2015). 

In a report released yesterday, CMS wrote that the legislation would effectively end the two-decades-old battle in Congress over annual cuts to the Medicare physician payments. But it also said Congress would need to pass more legislation to ensure that Medicare doctors do not lose out in the long-term.

“If not addressed by subsequent legislation, we expect that access to, and quality of, physicians’ services would deteriorate over time for beneficiaries,” Paul Spitalnic, the actuary for CMS, wrote in a report.

Spitalnic wrote that the new payment rates “would be adequate for many years,” but he was particularly concerned in years with high inflation. He also raised alarms that the funding package would expire in 2025 — forcing Congress to again confront the problem of provider payments.