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‘Doc Fix’ Up in Air in Fiscal Cliff Talks

Whether lawmakers will act to block scheduled cuts to Medicare physician payment rates before Jan. 1 remains up in the air, as discussions on a plan to avert the fiscal cliff deteriorated Sunday.

Although members of both parties in both chambers have said they would like to stop the payment reductions, the so-called doc fix has been caught up in the discussion with other items.

Senate Majority Whip Richard J. Durbin said a payment patch for physicians who see Medicare patients had been partnered with a proposal to limit the growth of Social Security benefits.

Republicans were pushing to include that proposal, known as the chained consumer price index (CPI), which would adjust government benefits with inflation. An extension of unemployment insurance (UI) benefits was also part of that package, Durbin said.

But Sunday afternoon, the chained CPI proposal was removed from current discussions to avoid the cliff — and the other items were set aside with it, at least temporarily.

“Now that CPI is off, I don’t know where UI is with the Republicans. We want it,” Durbin, D-Ill., said, referring to the Social Security and unemployment insurance items.

He added that the patch for Medicare physician payment rates was also attached to the chained CPI proposal — and thus still up in the air.

Senate Finance Chairman Max Baucus said Sunday he still hoped to reach an agreement between the two parties and include the Medicare payment patch in it.

“I’m still trying to put all the pieces together,” he said. “We’ve got a little ways to go, but I’m hopeful it’ll be done.”

“Today, tomorrow, or the next day, it’ll be done,” the Montana Democrat added.

If Congress doesn’t act, beginning Jan. 1, physicians will experience a 27 percent reduction in their Medicare reimbursement rates. A one-year patch to keep reimbursement rates at current levels is estimated to cost about $25 billion.

Humberto Sanchez contributed to this story.

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