Will Congress stop Medicare physician payment cuts?

A 21 percent reduction in Medicare Part B physician payments officially takes effect today after the Senate last week failed to follow in the House's footsteps and approve a measure to provide a temporary 30-day reprieve. However, the Centers for Medicare and Medicaid Services (CMS) anticipates that a deal will be worked out.

Late Friday afternoon, CMS issued an email message saying it would give Congress some wiggle room: "We believe Congress is working to avoid the negative update that will take effect March 1. Consequently, CMS has instructed its contactors to hold claims containing services paid under the MPFS [Medicare Physician Fee Schedule] for the first 10 business days of March. The holding of MPFS claims will only affect claims with dates of service March 1, 2010, and forward. This hold should have a 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."

A lone Republican, Sen. Jim Bunning (Ky.), stalled the Senate's efforts to delay the pay cut by issuing repeated objections. The stop-gap pay cut measure is part of a $10 billion bill to extend unemployment benefits and other expiring federal programs. Bunning declines to support a bill that he says isn't paid for.

The American Medical Association (AMA) describes the Senate's failure as the impetus for a "Medicare meltdown" that will "forc[e] many physicians to limit the number of Medicare and TRICARE patients they see in order to keep their practice doors open."

The Senate will reconvene this week to consider a bill that would delay the cut more than 30 days, according to a spokesman for Senate Majority Leader Harry Reid (D, Nev.). Details of the new bill are yet to be announced, but earlier proposals included pushing the pay cut back to Oct. 1.

The sustainable growth rate (SGR) formula that Medicare uses to set Part B reimbursement rates has mandated significant annual cuts for most of the last decade. As a result, physicians are seeking a permanent correction rather than continued temporary stays of execution from reduced Medicare reimbursements.

For more:
- see the American Medical News article [1]
- see the MedPage Today article [2]
- see the AMA press release [3]

Related Articles:
CMS assigns second-in-command despite lack of a leader, plans realignment [4]
Healthcare spending could be lower than anticipated, CMS says [5]
CMS: Proposed Medicare cuts could be disastrous to hospitals [6]