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Tuesday, June 1, 2010

Congress on Vacation until June 7th - Medicare Claims on Hold

For the third time this year, physicians face a 21% cut in Medicare reimbursement rates due to inaction by Congress. The House passed an amendment included in the tax extenders bill prior to the Memorial Day recess that would temporarily patch Medicare cuts for 19 months. The SGR amendment postpones the 21 percent Medicare physician payment cut an additional 19 months until Jan. 1, 2012. It provides a 2.2 percent increase on June 1, 2010 and an additional 1 percent increase on Jan. 1, 2011. However, in 2012 physician Medicare reimbursement would be cut by a reported 33 percent as the payment methodology reverts to the current SGR formula. The Senate is expected to begin debate on this bill and amendment when they return from recess June 7th.

The Centers for Medicare & Medicaid have instructed contractors to hold Medicare claims for 10 days; giving the Senate a few days to pass the House amendment without disrupting Medicare reimbursement. If the Senate makes any changes to the amendment, it will have to go back to the House to be voted on again before being sent to the President. In the meantime, physicians will be struggling to provide care to Medicare patients while Medicare patients will struggle to find physicians willing to accept them. Let's hope the Senate acts quickly when they return next week.