WASHINGTON – While there is widespread support on Capitol Hill for fixing the complicated payment formula used to reimburse physicians who participate in Medicare, an October 21 Senate vote shows there is no consensus on how to do that.

The Senate voted 53-47 against a bill introduced by Sen. Debbie Stabenow (D-Mich.) that would have frozenphysician payments where they currently stand for 10 years. The bill would have cost a quarter of a billion dollars.

Physicians now face a 21 percent Medicare physician payment cut in January 2010, although Congress has in the past made one-year fixes to prevent the cuts.

According to Stabenow, the Medicare Physician Fairness Act (S. 1776) would have protected Medicare for the future and prevented doctors from dropping from Medicare participation.

"The formula is complicated and does not reflect the reality of treatment costs," she said. "In fact, the formula has led to scheduled physician payment cuts for eight years in a row. Since the first cut in 2002, Congress used a band-aid approach that temporarily delays the cuts and pushes them off to the future."

J. James Rohack, MD, president of the American Medical Association, said the organization is "deeply disappointed" with the Senate's vote against the Stabenow bill. 

"While short-term fixes have temporarily averted widespread access problems, they have also grown the size of the problem – and the cost of reform," he said.

Sen. Susan Collins (R-Maine), who voted against the Stabenow bill, said the bill was not a "fix."

"I am sure that most physicians would agree that a permanent payment freeze does not remedy the problem," she said. "While Congress does need to correct the Medicare payment problem, this is not an honest solution."
Collins also said the bill is not fiscally responsible.

House Speaker Nancy Pelosi (D-Calif.) and other House leaders said they are committed to a permanent fix as part of a bill that would also provide a mechanism to pay for it.

"Fair payment and strong physician participation are essential for the stability of Medicare and to maintain access to care for its beneficiaries," the House leaders said in a statement.