A Medicare bill under consideration in the Senate Finance Committee that would reverse a reduction in physician reimbursements scheduled to take effect on Jan. 1 should not shift the cost of the reversal to future years, according to a draft letter from the American Medical Association addressed to the committee, CQ HealthBeat reports. AMA this week circulated the letter to other physician lobby groups for signatures but did not send the letter because Finance Committee Chair Max Baucus (D-Mont.) on Wednesday canceled the mark up of the Medicare bill in favor of direct negotiations with the House Ways and Means Committee (Armstrong/Carey, CQ HealthBeat, 12/6).

In recent weeks, Baucus has debated with committee Republicans over whether to reverse the reduction in Medicare physician reimbursements for one year or two years, as well as over reductions in Medicare Advantage payments to help fund the reversal. Baucus canceled a mark up of the Medicare bill one day after the Bush administration threatened to veto any legislation that includes reductions in MA reimbursements (Kaiser Daily Health Policy Report, 12/6).

The draft letter states, "We urge members of the Senate Finance Committee to develop" a sustainable growth rate provision that "properly funds a solution to this problem and does not rely on 'balloon' financing," adding, "If the Finance Committee were to propose such an approach, the undersigned organizations would be forced to oppose the proposal."

According to CQ HealthBeat, to address the issue in the past, "lawmakers have sometimes resorted to a 'budget gimmick' that uses much larger future cuts to provide an offset for more immediate spending." The practice "has caused a hole so deep lawmakers are having trouble finding the dollars to fill it," CQ HealthBeat reports (CQ HealthBeat, 12/6).