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The Boston Globe

Nation

Congress passes bill to stop cut to Medicare doctors

WASHINGTON — With just hours to spare, Congress stepped Monday to finalize legislation to prevent doctors who treat Medicare patients from being hit with a 24 percent cut in their payments from the government.

The Senate’s 64-to-35 vote sends a measure to delay the cuts for a year to President Obama, who is expected to quickly sign it. The House passed the measure last week.

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The $21 billion measure would stave off a 24 percent cut in Medicare reimbursements to doctors for a year and extend dozens of other expiring health care provisions such as higher payment rates for rural hospitals. The legislation is paid for by cuts to health care providers, but fully half of the cuts will not kick in for 10 years.

It is the seventeenth temporary ‘‘patch’’ to a broken payment formula that dates to 1997 and comes after lawmakers failed to reach a deal on financing a permanent fix.

The measure passed the House on Thursday, but only after top leaders in both parties engineered a voice vote when it became clear they were having difficulty mustering the two-thirds vote required to advance it under expedited procedures. Several top Democrats opposed the bill, saying it would take momentum away from the drive to permanently solve the payment formula problem.

There is widespread agreement on bipartisan legislation to redesign the payment formula that would give doctors 0.5 percent annual fee increases and implement reforms aimed at giving doctors incentives to provide less costly care. But there is no agreement on how to pay the approximately $140 billion cost of scrapping the old formula.

Senate Finance Committee chairman Ron Wyden, Democrat of Oregon, promised to keep pressing ahead with a long-term solution, proposing to use savings from the troop drawdown in Afghanistan to pay the cost. Republicans and most budget analysts say such savings are phony and are demanding at least some of the money to come from cuts to Obama’s Affordable Care Act.

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‘‘Paying for this through [war savings] is the mother of all gimmicks,’’ said Senator Jeff Sessions, Republican of Alabama.

‘‘We just don’t have the votes right now to fix this problem for good,’’ said majority leader Harry Reid, Democrat of Nevada, who negotiated the measure with House Speaker John A. Boehner, Republican of Ohio. ‘‘For the millions of elderly Americans and their doctors this fix is good news. It means the promise of accessible, quality health care to our nation’s seniors is being honored for another year.’’

The heavily lobbied measure blends $16 billion to address Medicare physicians’ payments with about $5 billion more for a variety of other expiring health care provisions, such as higher Medicare payments to rural hospitals and for ambulance rides in rural areas.

Manufacturers of certain drugs to treat kidney disease catch a break, as do dialysis providers and the state of California, which receives increases in Medicare physician fees in 14 counties.

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