FAQ: The ‘Doc Fix’ dilemma
United States (KaiserHealth) – Among the must-do issues on Congress’ end of year list is the “doc fix” – billions of dollars needed to avert drastic rate cuts for physicians who treat Medicare’s 48 million beneficiaries.
For doctors, the nail-biter has become a familiar but frustrating rite. Lawmakers invariably defer the cuts prescribed by a 1997 reimbursement formula, which everyone agrees is broken beyond repair. But the deferrals are temporary, and the doc fix has become increasingly difficult to push through a divided and deficit-wary Congress. Last year, Congress delayed scheduled cuts five times, with the longest patch lasting one year.
The script is no different heading into 2012. Should lawmakers fail to reach agreement before returning home for the holidays, a half million doctors will face a 27 percent cut beginning Jan. 1. Although Democratic and Republican leaders have pledged to stop that from happening, they disagree over how to offset the costs of a fix. While there is little doubt some agreement will be reached, a deal could be delayed until early 2012.
Here are some answers to frequently asked questions about the doc fix.
Q: How did this become an issue?
Today’s problem is a result of yesterday’s budget panacea – a 1997 deficit reduction law that called for setting Medicare physician payment rates through a formula based on economic growth. For the first few years, Medicare expenditures did not exceed the target and doctors received modest pay increases. But in 2002, doctors reacted with fury when they came in for a 4.8 percent pay cut. Every year since, Congress has staved off the scheduled cuts. But each deferral just increased the size – and price tag – of the fix needed the next time.
The formula also reinforces what many experts say are some of the worst aspects of the current fee-for-service system – rewarding doctors for providing more tests, more procedures and more visits, rather than for better, more effective care. In an Oct.- letter to lawmakers, the Medicare Payment Advisory Commission (MedPAC), which advises lawmakers on Medicare payments, called the formula “fundamentally flawed” and said it “has failed to restrain volume growth and, in fact, may have exacerbated it.”
Q. Why don’t lawmakers simply eliminate the formula?
Money is the biggest problem. It would cost about $300 billion to stop the doc fix cuts over the next decade and Congress can’t agree on where to find that kind of cash. Some lawmakers, including Sen. Jon Kyl of Arizona, the Senate Republican whip, have proposed using money saved from winding down the wars in Iraq and Afghanistan to finance a permanent fix. While the idea has found favor among some Democrats, other Republicans oppose it.
For physicians, the prospect of facing big payment cuts is a source of mounting frustration. Some say the uncertainty led them to quit the program, while others are threatening to do so. Still, defections have not been significant to date, according to MedPAC. Physician groups continue to lobby Congress to enact a permanent payment fix.
Q: What do experts recommend?
In October, MedPAC recommended eliminating the formula without increasing the deficit by cutting fees for specialists and imposing a 10-year freeze on rates for primary care physicians. That proposal was strongly opposed by health industry groups, as well as the American Medical Association (AMA).
The AMA has recommended a five-year transition fee scale that allows time to test new payment approaches, including several being tested as part of the 2010 health care law.
Several other options have been offered to fix the reimbursement scheme, including proposals by Rep. Allyson Schwartz, D-Pa., and the White House, but none has generated strong bipartisan interest.
Q: What happens next?
The Republican-led House passed a complex tax bill Dec. 13 that would extend doctors’ payments for two years at a cost of $38 billion. But that measure, which also includes the payroll tax break requested by President Obama, faces challenges in the Senate, where Democrats object to several provisions, including paying for the doc fix by cutting programs established by the 2010 health law and reducing Medicare and Medicaid payments to hospitals.
Some health care lobbyists suggest the Senate may go for a one-year fix, but there doesn’t seem to be consensus about what to do next. Since there are other major conflicts between the chambers on this bill, including the House’s approval of the controversial Keystone XL pipeline project, a physician payment compromise may be difficult to find. The White House has threatened a veto of the House Republican bill.
Lawmakers don’t have much time to reach common ground on the issue. Both the Senate and House are eager to break for the holidays and the current financing ends Dec. 31, well before they return to work. In the past when hitting such scheduling troubles, Congress has often opted for stop-gap extensions. If no deal is reached by Jan. 1, the agency that oversees Medicare would likely tell physicians to delay submitting claims in the expectation that Congress would pass a fix when it returns later in the month.
— Compiled by Mary Agnes Carey, Carol Eisenberg and Lexie Verdon
– Provided by Kaiser Health News.
Medicare ‘Doc Fix’ debate shifts to Senate
Washington, DC, United States (KaiserHealth) – KHN’s Mary Agnes Carey talks with Politico Pro’s Matt DoBias about the latest developments on Capitol Hill concerning a pending Medicare physician payment cut set to take effect Jan. 1 without passage of a “doc fix.”
MARY AGNES CAREY: Good day. This is Health On The Hill. I’m Mary Agnes Carey.
The House of Representatives has passed legislation that would stop a 27 percent cut in Medicare physician payments, scheduled to go into effect on Jan. 1. But the measure appears to be going nowhere in the Senate.
So what’s next for the Medicare “doc fix”? Matt DoBias of Politico Pro joins us today with the latest. It’s great to have you, Matt.
MATT DOBIAS: Good morning.
MARY AGNES CAREY: The House has passed a two-year patch for the Medicare doc fix. How would that work?
MATT DOBIAS: As you said, the first thing it does, probably most importantly, is it stops a 27 percent pay cut from hitting the physicians who are paid by Medicare starting in Jan. 1. What it also does, it gives them a slight bump up in pay. So it stretches over two years, starting in 2012, extending through 2013. In each of those years, physicians will get a 1 percent increase in Medicare reimbursement, something I’m sure they wanted a little bit more of, but they will be happy with 1 percent.
MARY AGNES CAREY: Senate Majority Leader Harry Reid has said the bill is dead on arrival in the Senate. Why?
MATT DOBIAS: Not just Harry Reid. President Obama also, his White House administration has issued a veto threat if it goes through, and there’s very little chance of that. One of the reasons why, and this is more of a political conversation, but along with the package that includes the Medicare doc fix are a couple of controversial what they call “riders” that Republican leadership included in there — one of them referring to a pipeline extension that would run from Canada down south through America. This is something that the Republicans want to accelerate the development of. Democrats want to slow it down.
There are a couple of other positions that just don’t jibe with the Democrats in the Senate and what they want. But primarily that seems to be the issue. There are these political arguments, and then there are also what they call the “pay-fors,” how they want to pay for this package. And the pay-fors really get into the Affordable Care Act. They siphon away close to $19 billion to pay for, not just the doc fix, but also other provisions that are in the bill.
MARY AGNES CAREY: So they are talking about – the bill would reduce funding, I believe, for the health law’s prevention fund. It would extend the current income-relating provisions that exist in Medicare. Is that correct?
MATT DOBIAS: That’s absolutely correct. And that is $8 billion coming out of the Medicare prevention and public health fund. Republicans have made it clear that they see this as a slush fund, but it has some very allies in the Senate and also in the White House. So that again is one of those provisions, one of those pay-fors, that will probably gum up the works.
MARY AGNES CAREY: Hospital groups have been very vocal. They are upset about these payment cuts for hospitals that are also being used to finance the doc fix. Has their lobbying campaign made a difference?
MATT DOBIAS: The hospital lobby really took it on the chin in this bill and it’s remarkable considering the amount of clout they have had and built up over the years. There are cuts in here that you never thought you would see. There’s $10 billion that will come out of what is known as “Medicare bad debt payments.” This is money that compensates hospitals for treating patients that can’t pay.
There are some other areas where they are getting hit. There’s a $6.8 billion hit in reimbursements for treating non-emergency patients in a hospital out-patient setting. And then there are some other tweaks that are a philosophical hit to hospitals. This is something that the American Hospital Association and the Federation of American Hospitals lobbied against and that is kind of a loosening of the rules for physician-ownership of specialty hospitals. So on one hand, yes, we know that hospitals are kind of Medicare’s biggest cost center. There’s more money that flows into that sector than any other sector paid by Medicare, including physicians. I think it is also an acknowledgement that the low hanging fruit – the easy pay-fors – when it comes to these types of provisions, these types of bills–are pretty much tapped out already.
But it also is an acknowledgement that the hospital lobby really, really did take one right on the chin. And I think that what happens when they go to the Senate — obviously hospitals have some pretty strong allies in the Senate as well. We’ll see how this shakes out.
MARY AGNES CAREY: Speaking of the Senate, has Senator Reid proposed his version of the doc fix?
MATT DOBIAS: Not yet. What the Senate has, is a version of the jobless benefits and the payroll tax break, and even that isn’t the match that the House passed last night. What is happening now is that the committees that have jurisdiction over Medicare on the Senate side, that is primarily being Senate Finance Committee, are quietly working, we assume, on a package that can run anywhere from a short-term fix to perhaps a longer-term fix. I think they’re still trying to calibrate the numbers right now. But, again, they’re facing somewhat of the same issue as the House phase and that is, trying to find a way to pay for a costly doc fix on their end.
What’s happened, we don’t know a lot at this point, but some of the ideas that have surfaced, the way that the Senate wants to pay for, if they can, a longer-term extension for physician payment — and that some of the provisions that we’ve heard would include: a surtax on millionaires and also what’s known as the OCO funds. This is O-C-O; it’s the acronym that’s basically shorthand for war savings. So the savings that would result as the U.S. kind of draws down its troops in Iraq and Afghanistan is also being thought as a way to pay for this package.
MARY AGNES CAREY: Thanks again, Matt DoBias of Politico Pro.
MATT DOBIAS: Anytime, Mary Agnes.
– Provided by Kaiser Health News.
Build your Credit with Pre Paid Cards
Having good credit helps not only to obtain a loan, but also to help you rent an appartment, buy a home or even get a job.
Your credit worthiness is important. People who want to do work with you want to know if you are able to pay them in time and if you have been responsible with your other creditors.
But, what if you have fallen in hard times. Maybe through no fault of your own you were not able to pay your bills in time because of loss of a job, illness, etc. Your credit may have suffered.
However now your circunstances changed and want to rebuild your credit. We have compiled a list of cards that have credit reporting features.
Account Now
Their money saving offers give consumers an alternative to “traditional” checking accounts and access to the financial and payment systems, including:
- Debit MasterCard or Prepaid Visa
- FREE Paycheck Direct Deposit
- FREE Online Bill Pay
- FDIC Insured Deposits
They Also include a Free Credit Builder. With AccountNow Online Bill Pay you can demostrate your credit worthiness paying your bills such as rent, cable, utilities, etc.
Everytime you make a payment with online bill pay, they report your bill payment information to a national credit reporting agency.
This feature is Free when you Activate your account now bill payment feature.
100% Guaranteed Approval Debit MasterCard
Rush Card
They give consumers an alternative to checking accounts and access to convenient money management tools, including:
- FREE Credit Builder
- Online Bill Pay
- FREE Paycheck, Benefits check, Tax refund Direct Deposit
- FREE Account Text Alerts
- FREE Interactive Money Management Interface
Bad Credit? No Credit? Get a Prepaid Visa RushCard
Horizon Gold
They Offer:
- Reports to Major Bureau
- Guaranteed 500 Unsecured Credit Limit
- Guaranteed Approval
- No Credit Check
- Fast Online Application
- No Employment Check
Want a $500.00 credit card? Guaranteed Instant Approval. Bad credit accepted. Reports to a major credit bureau. Apply Today!
No Assets to Pledge, Avail Unsecured Loans
If you are some body who does not own a home or if you are living as a tenant or does not have any valuable asset to put as a security backing for the amount which you want to avail as a loan. Then the loan product which do not demand any pledging of assets to secure the loan amount will be suitable for you. As this will be an unsecured loan where there is no need to secure the loan amount. People with bad credit can also avail this loan but the rate of interest will be on the higher side. There is no hard and fast rule, lenders analyze every case differently before granting the loan. The loan amount can be used according to the borrowers needs and lender has nothing to do with this.However,keep one thing in mind that these loans come at the higher rate of interest and repayment period is generally shorter.
There are various loan products which come under the category of unsecured loans such as personal loans, payday loans, tenant loans, non-homeowners loan, credit card loans, bad credit unsecured loans etc. For example, tenant loan is one of the very popular branch of unsecured loan category as it can be obtained by non-homeowners who have no property to pledge.
Tenant loans can be availed for amounts ranging from £1,000 to £50,000. Credit history, past defaults, payment overdues, late payment etc. do not alter your prospects of getting the loan as the main focus of lender is on your regular monthly income. The interest rate of this loan might be on the higher side as there is no security against the loan amount.Remember,you need to be a permanent resident of UK with 18 years or more in age and have to have a checking bank account. You can find numerous Unsecured Loans deals online with lots of offers to choose from.
Unsecured Bad Credit Loans: Collateral Free Money For Urgency
Do I carry high risk for lenders? What does it mean? Are you a tenant or non-homeowner looking for finance? If your answer is yes, then you carry high risk for lenders. Lenders put people into the category of high risk borrowers due to absence of collateral against the money. Such borrowers have to depend on unsecured bad credit loans. These are specially designed finance for bad credit history holders to meet their requirements. It can help you to repair your credit score if you make the payments on-time and can push to debt-trap if you don’t pay back the money on-time.
This money provides a fair chance to start new financial life for those people who have made many faults in making payments. Money faults can be anything like CCJs, missed rent payment, electricity or water bills, arrear, defaults, IVA, bankruptcy, missed credit card payments etc. All these faults are responsible for adverse credit history. Unsecured bad credit loans don’t ask to pledge any collateral against the money which means, lenders are dependent on the income documents, employment slips, bank statements and promise of borrower for the cash.
All those reasons are enough to charge high interest to cover the risk factor. Borrower can fetch the loan amount up to £25000 for 10-15 years. An individual can use the finance for any purpose like for home improvements, debt consolidation, wedding, divorce, medical emergency, rent payment etc. If you are looking for lenders who can offer cheapest deal of unsecured loans, then don’t visit here and there. You can find number of companies offering the millions of options on internet. Compare the maximum deal absolutely free of cost and select the best one.
Unsecured Bad Credit Loans: Collateral Free Money For Urgency
Do I carry high risk for lenders? What does it mean? Are you a tenant or non-homeowner looking for finance? If your answer is yes, then you carry high risk for lenders. Lenders put people into the category of high risk borrowers due to absence of collateral against the money. Such borrowers have to depend on unsecured bad credit loans. These are specially designed finance for bad credit history holders to meet their requirements. It can help you to repair your credit score if you make the payments on-time and can push to debt-trap if you don’t pay back the money on-time.
This money provides a fair chance to start new financial life for those people who have made many faults in making payments. Money faults can be anything like CCJs, missed rent payment, electricity or water bills, arrear, defaults, IVA, bankruptcy, missed credit card payments etc. All these faults are responsible for adverse credit history. Unsecured bad credit loans don’t ask to pledge any collateral against the money which means, lenders are dependent on the income documents, employment slips, bank statements and promise of borrower for the cash.
All those reasons are enough to charge high interest to cover the risk factor. Borrower can fetch the loan amount up to £25000 for 10-15 years. An individual can use the finance for any purpose like for home improvements, debt consolidation, wedding, divorce, medical emergency, rent payment etc. If you are looking for lenders who can offer cheapest deal of unsecured loans, then don’t visit here and there. You can find number of companies offering the millions of options on internet. Compare the maximum deal absolutely free of cost and select the best one.
Low Rate Personal Loans For Military Retirees
Getting a loan when you are in the military is easier than most people think. The problem is most places will take advantage and hike up interest rates. It’s sad actually how many loan places will take advantage of someone in the military. We found this out when my husband went through a place specifically for military, to get a car loan. We wound getting slammed with a twenty seven percent interest rate.
When it comes to getting a loan when you are military it really comes down to how bad do you need it? If it’s a matter of needing money to pay bills I would suggest going to your command first. The army has several programs to help soldiers and their families with necessities. In some cases an advance in pay is allowed also. Also there are some non profit groups who will help with bills, car maintenance, health care issues, and travel needs.
If you feel you really need to take a loan the army has a program called army emergency relief. This program will give you a loan, interest free and the payments come directly out of your paycheck. Still if for some reason none of these options work for you, there is only one place i would recommend. There are only a few places that specialize in military loans. I would recommend Omni financial. You do have to qualify, however they are quite understanding when it comes to credit issues. They offer a decent interest rate and the option to re-finance as long as you keep a good payment history. Also they don’t harass you if you are a few days late on your payment. I would also recommend staying away from pioneer loans. While they cater to military, they have rather high rates, and once you are even two days late they begin harassing you. We had a pioneer loan and offered to restart our monthly payments, but to no avail. They continue to harass us, yet they won’t take a partial payment.
In closing, always talk to your nco first. Often times the army will want you to take a financial budgeting class, but the class is actually quite helpful.There is a lot of financial help for soldiers. Try to stay away from loans and bank overdrafts, because they really do become a vicious cycle that can be impossible to get out of.
Bridging Loans: Grin Your Way To Home Sweet Home
There is a large array of people who have zeroed in on their new abode, or have simply locked in on to a property for investment purposes. The catch comes when the old property has not been sold and you have to make the payment for the new one fast, here is where the Bridging Loans come into play. They are short term loans that will provide you the money while the original home loan is processed.
Moreover, a growing number of people use this loan as a down payment for their new land, and pay the money at a slightly higher interest rate but over a period of a year or so, the time required to sell the old property and attain the cash that was initially held for the down payment.
Bridging Loans: An insight
Bridging Loans are offered by a lot of banks, but the interest rates differ and you must do a comprehensive research online before finalizing one particular type of bank for the same. The advent of the Internet makes it simple to browse through the options available in the market and saves on time, traveling and fuel costs. A mere click of the mouse can get you the entire process done online, saving you the bother of queues.
So, if you aim to get your hands on that prime piece of land that is so sought after by a lot more number of land sharks, be ahead of the race by applying for Bridging Loans and be the smart and suave customer who did the right thing at the right time, never going back on an opportunity offered. You would be surprised to see that most of the tensions of the bridge between the new property and the old property payments are vanished by the offering of these loans, bringing overall prosperity for all.
Instant Loans No Credit Check – Eliminate Past Worries For Urgency
Are you having some risky tags like late payments, payment defaults, arrears and CCJs in your name and mentioned in your credit report? Do you think that you will not be approved any loan for emergency purpose? If it is so than you are wrong. If you earn a monthly paycheque or get the salary bi-weekly and you are a UK citizen of 18 years of age or above, having a valid bank checking account, then you can apply for instant loans no credit checks. These loans are available to the UK people on Internet. Any simple online application with details of your monthly salary, employment record and home address etc can fetch you the loan amount within 24 hours in your bank checking account.
Because you get a paycheque regularly for past at least three to six months, as is the requirement of different lenders, they do not incur the risks. This is because you are supposed to repay the borrowed amount on next payday and you can make the repayment easily. This is the reason that even if you are carrying a bad credit history and your credit score has dipped, the lenders do not make credit checks on you. We can say that these are ideal loans for people like you who have a damaged credit record.
Instant loans no credit check can lend you £100 to £1500 for the period until your next payday. Clearly, these are easier loans to repay. You can borrow an amount against a post-dated cheque to the lender. On the due date, you can repay in cash and take back the cheque from the lender.
However, a little disadvantage is that these loans carry high APR. You may end up paying a huge amount of interest along with principal loan. But sometimes even such a loan is cheaper than the late payment penalties on credit card bills. You have the option of exploring numbers of offers of competitive instant loans no credit checks on Internet. Repay the loan amount on the set date to avoid the debts.
Gordon Mitchell is offering loan advice for quite some time. Apply For No Credit Check Loans UK has a vast network of lenders who provide loans to the borrowers at lower APR. To find Instant Loans No Credit Check, no credit check loans, loans without credit check, loans with no credit check, no credit check unsecured loans visit http://www.nocreditcheckloansuk.co.uk/ Article Source:http://www.articlesbase.com/loans-articles/instant-loans-no-credit-check-eliminate-past-worries-for-urgency-1396764.html
Motorcycles For Sale – Information is Powerful When Buying a New Motorcycle
Now that you are determined to obtain the motorbike of your dreams, the next step is gain adequate information before really buying it. Information, yes the right information is essential in deciding about the motorbike that you want to have.
Gather it all and jot down the vital things you need prior to conversing with a merchant. You can also check out the net for information such as various merchants cost for each type of bike. As a rule the merchants usually attempt to formulate about five to fifteen percent earnings from the transaction, so be reminded about this. There will be also a number of miscellaneous fees that you may have to pay. Thus do not be shock about this additional cost.
Be aware also that merchants would tend to offer optional parts that may be fitted to your motorbike to perform additional function. These are usually cash-making trends. However, it is your decision to acquire such optional parts. When you want to transact with your old motorbike as part of the payment, information is still the key. Right information, that is. Make sure you know how much would be the prevailing rate of your traded in motorbike. As said earlier merchants usually attempt to formulate about five to fifteen percent earnings from the transaction, thus right information would be a very big help to you.
The majority of merchants would like ready money transactions, however when loan is an option you are making then be sure to place a great amount of money as a partial payment. It is also suggested that having a private pay-later system or acquiring an advance borrow from financing organizations before going to a merchant is an excellent step to the motorbike of your dreams.
One thing to bear in mind is putting your old motorbike on the market personally would more or less gain you extra cash compared to transacting with your old motorbike as part of the payment. The merchant would always want you to buy what they are selling thus be tough on your choice. And when the transaction has agreed to meet halfway be sure also to reward the merchant a little by acquiring some accessories, after all he has exhausted an enormous amount of moment with you, as you decide for the right motorbike.
If you would like to find out how you can get a motorcycle loan, then visit the #1 motorcycle loan resource on the net: http://BadCredit-MotorcycleLoans.com Article Source:http://www.articlesbase.com/loans-articles/motorcycles-for-sale-information-is-powerful-when-buying-a-new-motorcycle-1320963.html
