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    AUA records victories in the Senate as 21.2% cut looms

    Senate's 'pay-as-you-go' bill could provide short-term fix


    Bob Gatty
    Washington—The election of Sen. Scott Brown (R-MA) to fill the late Sen. Edward M. Kennedy's (D-MA) seat put the future of health care reform in doubt because it meant Democrats had lost their supermajority in the Senate, thus allowing Republicans to block Democratic legislative initiatives. How much practical effect that will have is less clear, because the Democrats couldn't get together anyway, which is why health care reform wasn't finished before that fateful election.

    So as this issue of Urology Times went to press, passage of major health care reform legislation—on which AUA and other health care groups had devoted considerable time, energy, and resources—was in jeopardy.

    Also unclear was whether, or how, Congress would step in to prevent the 21.2% Medicare physician pay cut, scheduled for March 1, from being implemented.

    While the House of Representatives already approved legislation to establish a new system for determining physician fees under Medicare, replacing the hated sustainable growth rate (SGR) formula, the Senate was unable to pass the bill because of opposition from Republicans and centrist Democrats stemming from the fact that the 10-year cost of $240 billion was not offset with budget cuts elsewhere.

    Pay-as-you-go reprieve?

    Fast Facts
    However, action taken by the Senate in late January might have provided a path toward eliminating the SGR. With the blessing of the Obama administration, the Senate passed pay-as-you-go budgeting legislation that would require Congress to offset all new spending or tax cuts with cuts to existing spending or tax increases. The House passed a similar bill last year and was to take up another version in early February.

    The good news for physicians, however, is that the Senate's bill would allow Congress to spend up to $82 billion more on physician payments without offsetting that spending. While it's not enough to cover the complete cost of overhauling the payment system, it could be enough for some form of shorter-term fix.

    Although physician groups are talking tough and saying they "won't accept" a short-term solution, clearly that would be better than having to accept a whopping 21.2% average fee cut in one fell swoop.


    Bob Gatty
    Bob Gatty, a former congressional aide, covers news from Washington for Urology Times.


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