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Another potential offset is eliminating a temporary increase in Medicaid payments to primary care providers that is supposed to match higher Medicare rates. The 2010 health care law (PL 111-148, PL 111-152) funds the increase in Medicaid primary care physician payments for two years, starting Jan. 1.
But Democrats are deeply concerned about that potential cut to Medicaid primary care physicians, according to a Democratic aide.
In addition, a health care lobbyist said physician groups would make a coordinated effort to stop the use of the increased primary care payments as an offset.
Another offset seen as “low-hanging fruit” is to reduce payments to hospitals that treat large numbers of uninsured patients and those with Medicaid. Under the health care law, payments to those so-called disproportionate share hospitals are to be reduced by $18 billion between 2014 and 2020. The doc fix earlier this year extended those payment reductions by one year, and it’s possible they could be extended again this time.
Also under discussion as potential offsets are cutting reimbursements for skilled nursing facilities and reducing updated, increased payment rates for other providers and hospitals, according to lobbyists.
A doc fix that would last longer than one year is not likely to be on the table, stakeholders said.
But Sean Neary, communications director for the Senate Finance Committee, said Chairman Max Baucus, D-Mont., is working on the issue and wants to find a permanent solution if possible.
Paul M. Krawzak contributed to this story.