After many years of temporary deals tackling the Medicare “doc fix” situation, it looked like a solution was in place when the House had an overwhelming bipartisan vote to repeal the sustainable growth rate on Thursday. But the Senate has now put the process on hold and bailed for a two week recess due to some opposition (a decision was scheduled to be made Tuesday). This leaves reimbursement checks to doctors in limbo for the time being. The Senate’s vote won’t take place until after April 13.
Many are speaking out about the issues that could come as a result if the Senate doesn’t choose to repeal. Among them are Joel Allison and Robert Pryor, the chief executive and chief operating officers at Baylor Scott and White Health. They expressed their views on the issue in a Dallas Morning News editorial.
They are saying that the impending 21 percent cut in Medicare reimbursements will discourage physicians from seeing beneficiaries while “forcing others to abandon Medicare patients they see today.”
Should the repeal take place, it will set up a new reimbursement plan that built in incentives for value-based care and extended the Children’s Health Insurance Program for another two years.
Several doctors groups that had supported the SGR bill are also voicing frustration with the Senate’s lack of action.?? Two main ones are the American Medical Association and the American Academy of Family Physicians. Both have urged the Senate to make the bill its first priority after the two-week recess.
“The time to act is now. The House has provided an overwhelming bipartisan vote of approval. The Senate should do no less and should do so as quickly as possible,” the family doctor’s group wrote in a statement, according to The Hill. “Americans have already waited 12 years for this vote.”
[Photo from Flickr user Don Shall]
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
