Medicare Physician Payment Update Extension Act

Madam Speaker, I thank Mr. Pallone for his constant leadership on health care matters, and the Energy Committee and its full complement of members, as well as Mr. Stark for his continued strength on the issues of providing fairness and balance in the health care system of America. To the managers, my colleagues on the other side of the aisle, I appreciate the recognition that we have a bipartisan crisis and that we all have to address the pending concern of a potential cut as we move forward into 2011. But during the Thanksgiving holiday as I was in my district, I saw a table of doctors in a restaurant who felt compelled to come and ask me to support what is called the doctor fix, the Medicare fix. I had to assure them that Members of Congress were equally concerned about the providers of health care, the implementers of good health for America having to face this kind of dastardly crisis.

In the State of Texas it is crucial, a State that has the highest number of uninsured and a rising number of impoverished who do not have access to health care, this kind of disaster would be more than a hurricane. And so I rise today to support this legislation to acknowledge the fact that doctors and Medicare go together and they equal good health for our constituents.

Seniors have to go to doctors and expect good health care. Doctors are in fact those who take the oath to ensure that they care for the sick and the feeble. The Houston Chronicle reported that more than 300 Texas doctors have dropped the Medicare program in the last 2 years, 50 in the first 3 months of 2010, because of this crisis. Many people think of doctors as rich and able; but many of our doctors are in rural areas and inner city areas and their goal is to serve patients who are in need, many without any other means other than Medicare and Medicaid. According to Dr. Susan Bailey, president of the Texas Medical Association, the Medicare system has to be fixed and action must be taken to ensure that Medicare payments to physicians are not drastically cut. It is a shame to say, doctors have overhead, they have offices, they have nurses, they have equipment that they have to pay for, and that is part of good health care. And so I think it is important that we look at this legislation as it comes to us, and that the final physician rule, the Centers for Medicare and Medicaid Services, modify the MPPR policy to apply a 25 percent reduction rather than the proposed 50 percent reduction to physician Medicare payments. However, I think the reduction in itself is an oxymoron because the question is what are the needs of the patients and how can the doctors care for them and how do we ensure that doctors and Medicare work together to make sure that good health is promoted across America.

While that reduction shows movement in the right direction, any reduction will hinder the ability of doctors to effectively treat patients who need their care and who are the most vulnerable--pregnant women, children, the elderly and, of course, the feeble, who are suffering from preexisting diseases or chronic illnesses. So it is important that H.R. 5712, the Physician Payment and Therapy Relief Act of 2010, is passed.

What I would ask, Madam Speaker, is: Who are we if we cannot take care of the least of those?

I don't consider doctors wanting more than they deserve. I consider doctors getting what they deserve to help care for the sick of this Nation. I hope that we will have a bill that the President can sign and that we will be able to address the question of good health care in America.

Madam Speaker, I rise today in support of the amendment to H.R. 5712, ``The Physician Payment and Therapy Relief Act of 2010.''

Under the current health care law, more than 32 million additional Americans are expected to get insurance, either through an extension of Medicaid, the state-federal program for the poor, or through exchanges where low- and moderate-income individuals and families will be able to purchase private insurance with federal subsidies. The measure will require most Americans to have health insurance coverage; and it will regulate private insurers more closely, banning practices such as denial of care for pre-existing conditions. A key part of the new health law also encourages the development of ``accountable care organizations'' that would allow doctors to team up with each other and with hospitals, in new ways, to provide medical services. There are some very good provisions that seek to ultimately benefit the public.

Today, however, increasing numbers of doctors are not accepting Medicare patients because the payments they are receiving are inadequate to cover basic expenses of administering care. In fact the Houston Chronicle reported that more than 300 Texas doctors have dropped the program in the last two years, including 50 in the first three months of 2010. According to Dr. Susan Bailey, president of the Texas Medical Association, the Medicare system is on the verge of imploding unless action is taken by Congress to ensure that Medicare payments to physicians are not cut drastically.

Madam Speaker, I urge my colleagues to support not only H.R. 5712 but also the overall health of many struggling Americans. I am an avid supporter of health care reform and I stand today in steadfast support of providing affordable health care for all Americans. However, if doctors are unwilling to accept patients with Medicare because they fear they will not receive payment for their services we face a serious dilemma. It is our duty as legislators to provide such payment guidelines for the legislation intended to provide affordable quality health care for all Americans to ensure that it achieves is purpose.

In the final physician rule, Centers for Medicare and Medicaid Services modified the MPPR policy to apply a 25 percent reduction, rather than the proposed 50 percent reduction to physicians Medicare payments. While that reduction shows movement in the right direction, any reduction will hinder doctors' ability to effectively treat patients who need their care the most like children and the elderly.

I ask my colleagues to please join me in supporting H.R. 5712, the Physician Payment and Therapy Relief Act of 2010.

Madam Speaker, I move to suspend the rules and concur in the Senate amendments to the bill (H.R. 5712) to provide for certain clarifications and extensions under Medicare, Medicaid, and the Children's Health Insurance Program.

Madam Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and include extraneous material on concurring in the Senate amendments to H.R. 5712.

Madam Speaker, I yield myself such time as I may consume.

Madam Speaker, this bill is a stopgap measure to guarantee that seniors and military families can continue to see their doctors during December while we work on a solution for the next year. Without this legislation, the fees Medicare pays to physicians will be reduced by 23 percent on December 1, this Wednesday. And because TRICARE, the civilian health program for military families and retirees, uses Medicare rates, fees for physicians seeing TRICARE patients would be cut by 23 percent as well.

Madam Speaker, I have to say that kind of cut is obviously not reasonable. We have a responsibility to ensure that Medicare is a steady partner for physicians so that we are able to maintain the kind of excellent access to care that seniors and people with disabilities have come to expect from the program. Medicare enrollees still enjoy better access to care than anyone else in the country. The rate cuts created by the SGR would undermine that trust that seniors and physicians have historically had in the program.

The 111th Congress has passed into law three SGR extensions of less than a year, and this will be the fourth. I think we need to stop legislating SGR policy in 1 to 6 month intervals in order to provide some stability to the Medicare program for 2011. And I hope that before the 111th Congress adjourns, we can pass legislation addressing all of 2011 at a minimum.

I continue to be frustrated that we are unable to move beyond short- term fixes to this major problem facing the Medicare program. The House passed legislation in 2009 that I co-sponsored that would have dealt with this SGR problem for good; but until we have that long-term solution in hand, it is essential that Congress pass this legislation to ensure that seniors and military families do not experience a disruption in seeing their doctors this December.

This legislation, Madam Speaker, is completely paid for over 10 years. According to the rules of the statutory PAYGO law, we aren't supposed to pay for SGR bills; but this one is paid for despite that. It moved through the Senate by unanimous consent.

And so, Madam Speaker, there is no conceivable reason in my opinion to oppose this legislation. I would urge Members to vote ``yes'' on this bill and help me pursue a longer solution before Congress finishes business for this year.

I reserve the balance of my time.

Madam Speaker, I yield 3 minutes to the gentlewoman from Texas (Ms. Jackson Lee).

(Ms. JACKSON LEE of Texas asked and was given permission to revise and extend her remarks.)

I yield the gentlewoman another 30 seconds.

I yield myself such time as I may consume.

You know, Madam Speaker, I was very upset to hear the gentleman from California because I thought, for once--and it's very rare around here--as I heard the gentleman from Oregon suggest that he was supporting this bill, that we finally had some bipartisan support and some Republican support for the SGR doctors' fix; but now I listen to the gentleman from California, and he starts suggesting that somehow the Democrats are to blame. Well, let me suggest that the opposite is true.

Back in November of 2009, about a year ago, the Democrats in this House passed a permanent fix. We wouldn't be here today if that legislation had been supported by the Republicans. To his credit, only one Republican--Dr. Burgess, who is a member of my Health Subcommittee--did, in fact, support it, but he was the only one. It is the Republicans' fault that we are constantly dealing with these short- term fixes, because they don't want to take care of the doctors. They don't want to resolve this, and they refused to come to the table and resolve it with us while we were in the majority.

I don't want to go into it too much today because I know there is support on the Republican side of the aisle for this 60-day fix, until December 30; but in talking about the Democrats when the Republicans are the reason we are here today because they would not support the permanent fix and make it so that we didn't have to constantly go back to the table, I think it is totally inappropriate for the gentleman of California to lay blame when, in fact, it is his own party that is to blame.

I reserve the balance of my time.

Madam Speaker, I ask unanimous consent that the balance of my time on the majority side be controlled by Representative Stark of the Committee on Ways and Means.

I yield myself such time as I may consume.

Madam Speaker, for the fifth time in the last year, Democrats' ability to properly manage the Medicare program is causing medical doctors to confront a looming massive cut in their Medicare reimbursement rates. In fact, when the cut went into effect in June, Medicare held physicians' payments for weeks, and it ultimately was forced to pay claims that cut physicians' rates by 21 percent, only to later send additional payments once the majority congressional Democrats decided to pass another patch. In practical terms, this meant for weeks doctors and other providers saw no or greatly reduced Medicare payments, but yet they still had to pay their rents, payrolls, and other overhead expenses.

Madam Speaker, this is unacceptable and irresponsible. As a result of the Democrats' failure to address this issue in a timely manner, tens of millions of taxpayer dollars were wasted to reprocess physicians' claims and to send new checks to doctors all because the majority party could not finish its work on time.

Physician practices, like most small businesses, are hurt by this dereliction of duty. In a letter signed by 117 physician specialty and State medical societies, physicians detailed how many practices were forced to seek loans to make payroll expenses, to lay off staff or to cancel capital improvements and investments in electronic health records and other technology. Furthermore, when payments resumed, many physicians experienced long delays in receiving the retroactive adjustments. The physician group letter states, ``This is not the way to manage a program that seniors and the disabled rely on.''

The legislation before us provides for a 1-month postponement of the 23-percent cut; but in 1 month, the cuts return, this time even deeper, with payment cliffs expected to reach nearly 25 percent on January 1.

Madam Speaker, the Democrats' practice of missing deadlines, of withholding payments and reprocessing Medicare claims is no way to run the program. Furthermore, the Democrats' new health law cuts more than one half trillion dollars from Medicare but spends nothing on fixing the physician payment problem. It is one of the many reasons we should replace that flawed legislation with reform Americans can afford and that we should address a true long-term fix for our doctors and seniors. A Republican House will run this program differently.

We cannot miss deadlines. We must ensure doctors get paid on time for the services they provide. We cannot string them along not knowing from one month to the next what they will be getting paid by Medicare. As doctors are making decisions about whether or not to participate in Medicare next year, I want them to know that a Republican House will not leave them twisting in the wind as they have been this past year.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I would like to mention to my friend, the gentleman from New Jersey, that the legislation he speaks of, which they offered, had a $200 billion, non-paid-for bill on that. We have to begin living within our means, and through our legislation that we will be offering, we will be working to do that.

I reserve the balance of my time.

Madam Speaker, while I intend to support this bill and urge its passage, our work does not end here. We must find a long-term, stable and fiscally responsible solution to this problem.

Madam Speaker, I yield back the balance of my time.

Madam Speaker, I rise today in support of the Physician Payment and Therapy Relief Act.

On Wednesday, doctors who participate in Medicare will face a 21 percent cut in their reimbursement rates. It is unfortunate that we are again debating only a short-term solution to this problem. Thirty-day patches and 60-day fixes do not provide the certainty necessary for physicians to properly run their practices. Yet, inaction today would disrupt the Medicare system and jeopardize seniors' access to care just as the holidays are approaching.

We should pass H.R. 5712, but we must begin working on a long-term, financially viable solution to fix the manner in which physicians are reimbursed under Medicare. The first step must be to repeal the new health care law. The health law cut over $500 billion from Medicare to expand Medicaid and create a new entitlement program, while completely ignoring the looming payment crisis that we must act on with this legislation today. Unfortunately, I think for the last 4 years there has not been a single hearing held on this particular issue. That is long overdue to be done.

So while the majority scrambles today to find money to fix the Medicare reimbursement system, we should remember that they deliberately chose not to do this with their disastrous health care law. They needed the law to appear less expensive, and the Medicare doc fix was simply ignored.

I support H.R. 5712 to provide a temporary reprieve from the reimbursement cut scheduled to take effect Wednesday; however, we must find a solution to the pending 26 percent cut scheduled to take effect now in January. And we have to work together to develop a longer term solution that does bring stability to the Medicare program.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I rise today in strong support of H.R. 5712, ``The Physician Payment and Therapy Relief Act of 2010.'' One of the most important priorities of Congress, regardless of our current economic downturn, is the financial well-being of our Nation's hospitals, and the ability of patients to have access to medically necessary care when they need it.

Passage of H.R. 5712 accomplishes both goals by blocking the 23 percent cut in Medicare payments to doctors, for one month, while Congress and the Obama Administration work together to put together a permanent fix to ensure the optimal Medicare reimbursement rate to doctors and hospitals.

In order to have world class hospitals in the United States, we must have the needed funding to ensure that our Nation's hospitals can provide the highest quality care possible. Passage of H.R. 5712 will help strengthen our Nation's hospitals, especially those located in our inner cities and rural areas. Many of these hospitals are experiencing serious funding shortages, and are at risk of losing much needed doctors and medical staff.

H.R. 5712 is a bipartisan bill that costs one billion dollars, and is fully paid for. This legislation helps to protect access to doctors for Medicare beneficiaries and military families, given that payment rates for doctors in TRICARE, the health care program for active-duty service members, National Guard and Reserve members, military retirees, and their families are tied to Medicare rates.

H.R. 5712 is a good example of how Members of Congress working together in a spirit of bipartisan unity can improve the health and well being of all Americans. I encourage my colleagues to support the bill.