Medicare reimbursement cut postponed again

The dance to stop a 21 percent cut in reimbursement for Medicare patients continued to whirl Thursday night as Congress delayed the cut yet again, this time until June 1. The issue behind the large cut--that Medicare reimbursements are linked to the rise or fall of the nation's gross domestic product--is still not being addressed legislatively, meaning swings in potential reimbursement will continue as the economy ebbs and flows.

Although the pay cut technically went into effect April 1, the Centers for Medicare and Medicaid Services has held claims anticipating the Congressional move, which, in a house vote of 289-112, postponed the physician pay cut. The Senate voted, 59-38, to postpone the cut.

While the reprieve has led to a collective sigh in the physician industry, the American Medical Association is pushing that Congress adjust the equation that decides reimbursement rates so there aren't such large swings.

"It is impossible for physicians to continue to care for all seniors when Medicare payments fall so far below the cost of providing care," said J. James Rohack, MD, president of the American Medical Association, in a statement.

An AMA informal poll shows that 68 percent of physicians feel they will have to limit the number of Medicare patients in their practices because of potential reimbursement issues. 

The sustainable growth rate formula, which determines Part B reimbursement, was designed to match increases in physician payments to the growth in the GDP. With medical costs outstripping the GDP for years, reimbursement would have fallen for years in Congress had not stair-stepped decreases or postponed cuts. 

To learn more:
- read the Medpage Today story [1]
- read the American Medical Association's statement [2]

Related Articles:
Doctors dropping patients as Medicare reimbursement cut looms [3]
Will Congress stop Medicare physician payment cuts? [4]
Congressional inaction means cut to Medicare physician payments [5]