[Congressional Record (Bound Edition), Volume 160 (2014), Part 5]
[Senate]
[Pages 6188-6189]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   MEDICARE PHYSICIAN PAYMENT SYSTEM

  Mr. FRANKEN. Mr. President, recently the Senate failed to permanently 
repeal the current system of automatic payment cuts for physicians who 
treat Medicare patients and to replace it with a more sensible system 
for reimbursing physicians. Instead, the Senate voted--yet again--to 
pass a short-term patch to this broken system, which postponed these 
payment cuts for one more year.
  After talking with Medicare providers in my State, I decided to 
oppose

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this legislation since it provides only a bandaid for a wholly broken 
system. I believe that an enduring solution is possible and absolutely 
necessary, and I will continue to fight for a more sustainable 
replacement that rewards physicians for the high-quality care they 
deliver.
  Minnesota is No. 1 in the Nation when it comes to the quality of the 
health care that we provide. If our system of reimbursement could 
reward providers for their efficiency and quality--rather than the 
quantity of the services they administer--we could improve the value of 
the care that our seniors receive while rewarding providers who keep 
patients healthy. We can do that by overhauling the Medicare physician 
payment formula and implementing a system that rewards health care 
value over volume, and there has never been a better moment to do that 
than now. Over the past 10 years, Congress has spent $150 billion on 
short-term fixes; the Congressional Budget Office estimated earlier 
this year that the cost of permanently repealing the formula and 
replacing it with a more sustainable program now would be even lower 
than that total so far. For the first time since the passage of our 
current formula, there was bipartisan, bicameral legislation to fully 
repeal the Medicare physician payment formula and replace it with a 
payment system that would better reward physicians for providing high-
value care.
  We have a unique opportunity to permanently solve this problem. 
Temporary patches--like the one just passed--only perpetuate the 
instability created by the annual threat of payment reductions. This 
instability is bad for patients and bad for providers. Take, for 
example, the young physician from Rogers, MN who recently called my 
office to discuss how proposed payment cuts would affect his practice 
and his future. As a father and a new surgeon, this doctor described 
the challenges of paying off high levels of debt and starting a new 
practice in a time of financial uncertainty. Temporary fixes will not 
help this young doctor to establish a practice and provide the best 
possible care to his patients. Stopgap measures fail to address the 
underlying problem with the way Medicare pays for physician services, 
and I am tired of postponing good policies that help support high-
quality providers in Minnesota.
  It is clear that now is time to permanently repeal and replace the 
Medicare physician payment formula. That is why I did not support the 
legislation to temporarily patch our provider payment system and why I 
am committed to working towards a permanent solution that would put in 
place a payment system to reward high-value care.
  My goal is to make sure that Medicare beneficiaries, now and in the 
future, have access to high-quality, affordable health care services. 
To achieve this, Medicare must be on sound financial footing and be 
prepared to meet the needs of an aging baby boomer generation.
  Replacing Medicare's broken system of provider payments with a system 
to promote high-value care is a critical step in this direction. I 
remain committed to helping to take this step.

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