As the deadline of February 29 rapidly approaches, House and Senate negotiators continue to remain at an impasse on how to address the looming Medicare physician pay cut. Starting March 1, 2012, physician fees will be cut by 27 percent if an agreement is not reached to avoid the cuts with either a short- or long-term fix. The bipartisan group of lawmakers, several of whom also served on the failed Supercommittee last fall, have been considering proposals that would pay for a fix that lasts anywhere from 1 to 10 years. The disagreement on how to pay for the fix, which the Congressional Budget Office believes would be between $9 billion (one - year fix) and $316 billion (10 - year fix), does not always fall cleanly along partisan lines. Republican negotiators disagree among themselves on using war savings to cover part of the cost of the doc pay fix. Democrats have opposed House Republican proposals for significant cuts to hospitals to make up the cost. MedPAC data citing significantly higher Medicare costs for physician services performed in a hospital outpatient department versus a physician office have painted a bit of bull 's eye on the hospitals, who are aggressively pushing back. If war funds are not an option, health providers fear cannibalism as the provider community seeks to protect its own and avoid being part of a list of offsets for a doc pay fix. Indeed, the same stalemate that affected the Supercommittee and House-Senate discussions that followed at the end of 2011 has reared its head again. This time, the deal - making is further complicated by election-year politics on an issue that affects the future of physician participation in Medicare, and therefore, access to Medicare services.
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