Bobs Blog

Senate failure to pass 30-day extension causes 21.3 percent cut to Medicare physician payments on April 1

The Senate has adjourned for its two-week “Spring District Work Recess” without approving H.R. 4851, a short-term measure that would have extended the freeze on Medicare’s current physician payment rates through April 30. Several Senate Republicans led by Tom Coburn of Oklahoma objected to classifying the bill, which also included extensions of unemployment benefits and COBRA insurance, as emergency spending. The House of Representatives passed the bill on March 17. By law, the 21.3 percent cut to Medicare physician payments will take effect April 1.

CMS has instructed its contractors (Palmetto) to hold claims for services after April 1 to be held for the first 10 business days of April.  They state the “hold” should have minimum impact on provider cash flow because, under current law, clean electronic claims are not paid any sooner than 14 calendar days (29 for paper claims) after the date of receipt. 

The Senate will return on April 12, from Spring Recess, which will mean they have two days to pass the bill to extend the freeze on preventing the 21% cut in Medicare.  If you are so inclined an E-mail to our Senators might not hurt, http://feinstein.senate.gov -or- http://boxer.senate.gov/en/contact

March 2010 Client Alert

Please see the link below to read the March 2010 MMS client alert including Medicare delaying the Pecos enrollment, a summary of the comprehensive error rate testing program, Aetna’s new fee schedule and much more.

Please click this link to read the entire client alert.

Thanks

-Bob

Senate Approves Delaying Physician Pay Cut Until October 1

The Senate voted this afternoon to delay a 21.2% physician pay cut in Medicare reimbursement until October 1. 

Overall, the Senate approved a $138 billion package of legislation, including tax extenders and unemployment aid that the White House said is critically important to the country’s economic recovery.

 The vote was 62 to 36.

 On Tuesday, the Senate voted to limit the bill’s debate, with President Obama saying he was “grateful to members of both parties that helped move forward on this bill, ” said White House Press Secretary Robert Gibbs.

 The Senate included an amendment by Senate Finance Committee Chairman Max Baucus, D-MT, to the American Workers, State and Business Relief Act that would delay the Medicare payment cut for physicians—that was supposed to go into effect March 1— until October 1.

 The American Medical Association stated the Baucus bill appeared to be a compromise between senators who wanted to implement a one-year payment fix and others who were seeking another “short bridge” to give Congress more time to possibly repeal the formula that calls for annual physician payment cuts.

-Bob

Senate Inches Closer to Delay Doc Pay Cut until September 30

The Senate has cleared the way to vote on delaying a 21.2% physician pay cut vote in Medicare reimbursement until September 30.

In a procedural action, the Senate voted Tuesday to move on a $150 billion package of legislation, including tax extenders and unemployment aid that the White House said is critically important to the country’s economic recovery. The final vote may take place today.

Reacting to the 66-34 vote, President Obama said he was “grateful to members of both parties that helped move forward on this bill, ” according to White House Press Secretary Robert Gibbs. Fifty-eight Democrats and eight Republicans voted for cloture, to limit debate on the measures or a GOP filibuster, which has been a predominant theme in the Senate the last two weeks.

The Senate is considering an amendment by Senate Finance Committee Chairman Max Baucus, D-MT, to the American Workers, State and Business Relief Act that would delay the Medicare payment cut for physicians—that was supposed to go into effect March 1— until September 30.

The Medicare payments were scheduled to be cut across the board in accordance with the sustainable growth rate (SGR) formula. The proposed delay may give Congress time to adjust the SGR formula. SGR links Part B Medicare reimbursement to the gross domestic product. The formula has led to proposed large cuts annually, which physicians have successfully worked to delay.

Physician groups have strongly opposed the SGR formula and some have urged Congress to drop it and rethink the payment process as part of healthcare reform. The pay cut issue has been continually dependent on congressional action. Last week, the Senate and House voted to continue delaying the scheduled pay cut 30 days to April 1. On Dec. 19, Congress voted to delay the scheduled payment cut until March 1.

-Bob

Special Medicare payment update: President signs extension of physician payment freeze

 Late last night, the president signed H.R. 4691, the Temporary Extension Act of 2010 into law. This legislation includes a provision that freezes Medicare physician payments at their current level until March 31, 2010. The legislation also extends the therapy cap exception process through until March 31, 2010.  The bill passed the Senate by a vote of 78 – 19.  The House of Representatives had unanimously approved a companion bill by voice vote on Feb. 25. 

Medicare 10 day business hold for claims processing

You will most likely see a period toward the middle to end of March 2010 where your Medicare payments will slow down, due to the Medicare program holding the processing of all claims for the first 10 business days of March.  MMS will diligently monitor the Medicare batches of claims for the next 45 days to make sure all batches are being processed by Medicare after the 10 business day hold is ended on March 15, 2010.