News in brief - Jan. 16, 2012

Conferees named to negotiate Medicare pay solution - Nearly 9 in 10 Florida physicians say they practice defensive medicine - Judge halts California Medicaid cut to nursing homes

Conferees named to negotiate Medicare pay solution

Leaders in the House and Senate have appointed all of the members to a conference committee charged with negotiating payroll tax extension legislation that also will address Medicare physician payment rates for the rest of 2012.

On Dec. 23, 2011, Congress approved a delay of a 27.4% cut to physician payments for two months, buying more time for the two chambers to reconcile differences over a longer extension of current Medicare rates and a payroll tax holiday. Congressional leaders in passing the short-term bill agreed to appoint conferees who would negotiate a longer-term bill before March 1, when the Medicare cut otherwise will return.

House leaders have named Reps. Kevin Brady (R, Texas), Dave Camp (R, Mich.), Renee Ellmers (R, N.C.), Nan Hayworth (R, N.Y.), Tom Price, MD (R, Ga.), Tom Reed (R, N.Y.), Fred Upton (R, Mich.), Greg Walden (R, Ore.), Sandy Levin (D, Mich.), Xavier Becerra (D, Calif.), Chris Van Hollen (D, Md.), Allyson Schwartz (D, Pa.) and Henry Waxman (D, Calif.). Senate negotiators are Sens. Max Baucus (D, Mont.), Jack Reed (D, R.I.), Benjamin Cardin (D, Md.), Bob Casey (D, Pa.), Jon Kyl (R, Ariz.), Mike Crapo (R, Idaho) and John Barrasso, MD (R, Wyo.).

The House officially will return from its holiday recess on Jan. 17. The Senate is set to reconvene on Jan. 23.

Nearly 9 in 10 Florida physicians say they practice defensive medicine

Eighty-eight percent of Florida doctors said they practiced defensive medicine in the previous 12 months. The same physicians estimated that one-third of health care spending in Florida is related to defensive medicine, according to a representative poll of 321 Florida doctors conducted in December 2011 on behalf of Patients for Fair Compensation, a nonprofit organization advocating for medical liability reform.

The poll defined defensive medicine as the "practice of ordering medical tests, procedures or consultations of doubtful value in order to protect the prescribing physician from malpractice suits."

"Doctors order unnecessary medical care because they are in fear that one mistake could wipe out everything they've ever worked for," said Richard L. Jackson, chair of Patients for Fair Compensation. He's also chair and CEO of Jackson Healthcare, a management and technology company based in the Atlanta area. Patients for Fair Compensation is advocating for legislation to reform medical liability into a no-fault system similar to workers' compensation.

Judge halts California Medicaid cut to nursing homes

A California judge on Dec. 28, 2011, blocked the state's plan to cut Medicaid rates to skilled nursing facilities that are part of acute care hospitals, after a lawsuit by the California Hospital Assn.

The Centers for Medicare & Medicaid Services in late October 2011 approved a 10% rate reduction to the skilled nursing facilities, which would be retroactive to June 1, 2011. However, the CHA said the cuts would end up being closer to 20%, because they are based on payment rates from 2008 and 2009.

In her opinion, U.S. District Judge Christina Snyder said CMS "failed to consider whether [California] relied on responsible cost studies" before approving the state's request to slash payments to hospitals and health care professionals. The judge concluded that the state's plan to monitor access to care in light of the payment cuts would not prevent Medicaid patients from being harmed (www.dhcs.ca.gov/Documents/DHCS Budget Actions/CHA.OrderGrantingPI.pdf).

The state plans to appeal the ruling.