Senate's McConnell optimistic on swift Medicare 'doc fix'

WASHINGTON (Reuters) - With deep cuts in Medicare payments to U.S. physicians looming, Senate Majority Leader Mitch McConnell said on Tuesday he was optimistic that a bill would pass before midnight to avert the cuts and permanently fix the way Medicare pays doctors.

If the Senate approves the bill and President Barack Obama signs it into law, it would shape up as the first substantive legislative achievement of the 2015-2016 Congress, suggesting some progress toward easing years of gridlock on Capitol Hill.

If the Senate does not act on the measure, or rejects it, doctors nationwide who take part in the Medicare program for the elderly on Wednesday will face a 21-percent cut in their pay.

The formula for paying Medicare doctors has been a problem for years, addressed by a series of temporary "doc fix" patches.

In a rare show of bipartisan accord, the House of Representatives last month voted to fix the Medicare pay formula for good, in an effort driven forward by Republican House Speaker John Boehner and House Democratic Leader Nancy Pelosi.

But the House's solution would expand the federal deficit. Greeted skeptically by deficit hawks, the House measure was sent to the Senate two weeks ago.

Obama, a Democrat, said in late March he would sign "a good, bipartisan bill" to fix Medicare's physician payment system.

Healthcare groups back the measure and are leaning hard on the Senate to pass it. McConnell argued for approval.

"It's a bill well worth supporting. We also need to pass it today and I think most of our members understand that," McConnell told reporters in the Capitol. Congress reconvened on Monday after a two-week break.

McConnell said votes on several amendments were expected ahead of the final vote. At least one amendment is expected to require lawmakers to find a way to fully pay for the measure, but any Senate changes would send the bill back to the House.

"Honestly, it's my hope that the amendments are not approved because we need to get this bill down to the president for signature before midnight, and I’m optimistic and hopeful we’ll be able to do that," McConnell told reporters.

As approved by the House in late March, the $214 billion initiative would replace a 1990s formula that linked Medicare doctors' reimbursements to economic growth with a new formula more focused on quality of care.

Some Senate conservatives have labeled the House bill irresponsible because it would add an estimated $141 billion to the U.S. debt over the next 10 years, according to the Congressional Budget Office (CBO).

Republican Senator Mike Lee said earlier on Tuesday he would offer an amendment requiring Congress to find ways to pay for the "doc fix" by the end of this year.

"Paying for this new spending is the right thing to do. And we just passed a budget promising that we would do it," Lee said on the Senate floor. "My amendment does nothing more than hold us to that very promise."

One of the government's largest social safety net programs, Medicare is health insurance that serves 54 million elderly and disabled people.

The federal government warned Congress last week that it must act before April 15 or Medicare doctors will face a pay cut. However, Democratic Senator Ron Wyden said doctors would be paid in full later at the new rate once the bill passes, because the measure is retroactive to April 1.

(Additional reporting by Lisa Lambert; Editing by Kevin Drawbaugh, Sandra Maler and Christian Plumb)