This Congress may be a Lame Duck, but that didn’t stop the Senate from at least one unanimous decision. Yesterday, December 8, 2010, the Senate passed legislation to extend Medicare payments for another year. With just 3 weeks left before the massive 25% pay cut to physicians would have taken place, and since the House must still pass the same action before they break for the rest of the year, it’s fair to say they’ve cut it a bit close. Since there was unanimous consent, one wonders why this wasn’t passed long ago. Perhaps the answer lies in figuring out how to pay for it, but this seems unlikely as well.

The Senate bill suggests that the money come from what would have been overpayments restitution from the Healthcare Affordability tax credits. At this time, the maximum a household is required to repay is between $250 and $400. The new bill suggests making the cap based on a sliding scale, relative to the taxpayer’s income. It is not at all clear how this would actually generate enough funding to cover 25% of the cost of Medicare. As we have held before, it doesn’t really matter where the paper chase pulls the funds from, as it is a bill which must be paid.

A bipartisan effort from Harry Reid (D, NV) Mitch McConnell (R, KY), Senate leaders, and Max Baucus (D, MT) and Chuck Grassley (R, IA), Senate Finance Committee, this bill could easily have been passed long ago. Of course, physicians are relieved that it has not come to the point of turning away patients, but it’s fair to demand answers as to why this is down to the wire yet again. The debt is not in question, so full payment of the reduced rates that Medicare enjoys should not be in question either.

While the AMA congratulates the bipartisan Senate effort, we here at Medical Justice find it should not be necessary to applaud them for doing their job. The Senate bill still only provides for one year’s payments, and that after four short-term bandages and a month when payments were not issued because a band-aid had not been passed in timely fashion. The last cliffhanger came to a head when the department responsible for cutting checks declined to do so (though they had assumed the band-aids would be issued several times in the past,) citing that they were not authorized to make payment without Congressional approval.

Congress has been markedly irresponsible in attending to its Medicare obligations. We hope that the House resolves their bill swiftly, but also urge both the House and Senate to see to a long-term bill in the first quarter of this coming year. As there is no question about the validity of the debt, neither doctors nor patients should be left on a lurch like this, time after time.