Permanent 'Doc Fix' Could Shift K Street Business

Permanent 'Doc Fix' Could Shift K Street Business

By Kate Ackley, CQ Roll Call

Some health care lobbyists pushing for a permanent “doc fix” say privately they are beginning to fret about what a long-term solution would mean for their own business.

Though lawmakers’ negotiations on a deal to replace the sustainable growth rate formula could ultimately fizzle, lobbyists said the possibility of a bipartisan bargain is enough to get them looking at their own long-term business plans.

It’s not just that the annual business of securing the “doc fix” itself could disappear, these sources say, but that a long-term solution would remove what has become a must-pass Medicare vehicle in a Congress that doesn’t pass a lot of bills.

Congress also searches for “payfors” in patching the payment formula to doctors so they don’t see cuts to their reimbursement rates. And since no industry or company wants to be a pay-for, that also generates business for lobbyists too.

“It would be a significant blow to the health care lobbying sector,” said one veteran health care consultant, who would only speak anonymously to avoid conflicts with client interests.

Another health care lobbyist, also speaking on background, agreed. “In such a dysfunctional Congress, the doc fix is a sure thing. It gets done,” the lobbyist said. “From that standpoint, it’s absolutely true” that it could change the annual dynamic of health care lobbying.

The current payment patch expires March 31, and lawmakers are trying to permanently resolve the issue to avoid passing what would be the 18th temporary “doc fix” since 2003.

The issue generates work for lobbyists across the health continuum. More than 350 clients reported working on SGR or “doc fix” issues in the final three months of last year, according to the most recently available Lobbying Disclosure Act filings with Congress.

Big health-care-focused groups such as the American Medical Association and the senior lobby AARP want a permanent resolution. An AMA spokeswoman said her group had numerous other priorities on its lobbying agenda, including regulatory efforts, electronic health records and disease prevention programs.

AARP’s Andrew Scholnick, a senior legislative representative for the group, said that even without the SGR, “AARP has many health care priorities for which we will continue to advocate.”

And some lobbyists, despite the worries of their colleagues around town, said that without the annual “doc fix” drama, perhaps Congress might have more time to consider the sector’s other legislative priorities.

“Congress has never been so close to eliminating this failed formula,” said Miranda Franco, a health care adviser at Holland & Knight. “Permanently repealing the SGR would remove a great source of distraction in the health policy community to focus on other health priorities like 21st Century Cures.”