- The Senate on Tuesday night passed the bipartisan "doc fix" legislation with a 92-8 vote, permanently repealing the much-hated sustainable growth rate formula for Medicare payments and avoiding a 21% pay cut that would have gone into effect today.
- While several amendments to the bill were raised, none passed, including a 58-42 defeat of a proposed requirement that Congress pay for the package in its entirety. Twelve Republicans voted against the measure, notable in the face of widespread conservative funding concerns that threatened to derail the bill in the Senate.
- The bill now goes to President Obama's desk, where it is expected that he will quickly sign it into law.
The American Medical Association called the vote "a great victory," writing in a statement that "the new legislation removes much of the instability and uncertainty that long has plagued the Medicare payment system."
"It's a solution to a broken Medicare payment system that had vexed congressional leaders of both parties for years," Senate Majority Leader Mitch McConnell said. "It would mean an end to the annual exercise of Congress passing a temporary 'fix' to the problem one year and then coming right up to the very same cliff the next year, without actually solving the underlying problem."
The package extends funding for CHIP for two years and provides a 0.5% pay increase for physicians each year until 2019. Physicians that have tied at least 25% of their Medicare revenue to alternative payments would then be eligible for increased reimbursement. (That threshold goes up to 75% in 2023, but physicians could count all revenue sources, not just Medicare.) Otherwise, payment rates freeze for six years in 2019 before going to 0.25% annual increases.
The package also includes a six-month delay of the controversial "two midnight" inpatient rule.