Possible 21.2% Decrease in Medicare Reimbursement 3/1/10

[dr.dreama.kelly]

Medicare Payment to decrease 21.2% -- 3/1/10

Did you know that the 21.2% decrease to Medicare payments you heard everyone talking about last year is slated to go into affect once again as of March 1, 2010? Most people do not know this is the case but here is the whole story. Close to the end of last year, Christmas Eve to be exact, a bill was attached to the defense appropriations bill to put a stop to the 21.2% in Medicare reimbursements. This bill passed, and at first glance, it was a relief to see that doctor groups would not be affected by the drastic cut. However, closer analysis proved anything but good news. The bill assumed that healthcare reform would indeed pass by March, so a provision was placed on the bill that the fix would become null and void the first day of March 2010. With the election of Scott Brown to the Senate to replace Senator Kennedy, and the loss of the majority needed to pass the bill by the Democrats, we are caught in a huge conundrum.

So what do you need to know? The American Medical Association (AMA) is making a concerted effort to get physicians to become active in lobbying their congress men and women to put a stop to the pending decrease in Medicare reimbursements. Encourage your doctors to call their local political leaders to try to affect change. Secondly, be prepared to hold claims as of March 1st if you do not hear that a fix has been put in place. This is similar to what we had to do about a year and a half ago. The reason to hold the claim is in the hopes that the decrease will be addressed at a later date – hopefully within the same month. Lastly, stay on top of what is going on – here are a few links that should be of help to you:

http://www.ama-assn.org/ama/pub/physici ... care.shtml

http://www.ama-assn.org/ama1/pub/upload ... -flyer.pdf

As always I will keep you posted as to any changes I hear coming down the pike!

UPDATE:

I just received this email from the AMA:
Feb. 25, 2010

Congress continues to debate short-term SGR patch

There have been several developments regarding Medicare’s sustainable growth rate (SGR) formula during the past two days that require some clarification.

Last night, the U.S. Senate passed H.R. 3961, which in its original form was the U.S. House of Representatives vehicle that repealed the SGR. However, the Senate used the bill as a shell to move a one-year extension of the Patriot Act, so H.R. 3961 as passed by the Senate has nothing to do with the SGR.

Also last night, Senate Majority Leader Harry Reid, D-Nev., attempted to pass by unanimous consent the Temporary Extension Act of 2010. This package extends several expiring provisions, including stopping cuts under the SGR, unemployment insurance and COBRA for 30 days. Most of the $10 billion cost of the bill was designated as emergency spending and not offset. The SGR provision did not require an offset under "pay-as-you-go," or pay-go, rules. Sen. Jim Bunning, R-Ky., objected and attempted to move a similar bill that was paid for with a reduction in stimulus money. Sen. Reid noted that he had offered to hold a separate vote on paying for the bill. However, Sen. Bunning objected, insisting that the "pay-for" be included rather than be subject to a separate vote.

Negotiations on the 30-day extension are continuing today. The House may also move the 30-day extension today under suspension of the rules. That vote will require two-thirds support for approval.

Finally, the Senate plans to move a broader package of tax and other extenders next week. That bill is expected to contain the seven-month SGR extension that was stripped from the Senate jobs bill that passed earlier this week. The AMA does not support temporary extensions of the SGR and continues to insist that Congress repeal the current formula once and for all.

Despite the uncertainty, the AMA does not expect any disruptions in processing Medicare physician claims next week. The AMA will continue to keep you informed as this situation develops.


Until next time…….