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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
- see the MedPage Today article
- see the AMA press release

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

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Comments

A 21% cut across the board is really a big joke.
It's nice to know that all health care workers will be getting a lovely pay cut as well due to this cut.
I have a two kids to support with no help from there dead beat father. I went back to school to better myself and make more income for my family.
Now I will be as if I wasted all my time. I will barely be able to make ends meet.
It's nice to know that the gov. thinks that someone who does testing that determines weather some could live or die should be done by someone $7 and hour.
My education is worth nothing to them. How about the gov. Crack down on medical fraud. Punish the doctors that abuse the system and not the employees and Doctors that bust there ass and do things by the book.
Tell me Mr. President What kind of care will you expect from over worked and under paid medical doc's and staff.
Oh, Yes I forget, I used to work in a hospital where people like you get special treatment. It must be nice not to have to worry where your family is going get there meal from or if they will have a roof over there head for the future.
Just wanted to thank you for making my future soooo bright.
I wish you and your family the same out come that you brought upon the american people.
Hope and change. This isn't the hope and change you promised..

Ms Pinto: I am sorry for your difficulties. Too many Americans struggle to get by. However please read the article carefully. The President is not causing this to happen. It is a Republican Senator named Senator Bunning from Kentucky.

The President and Congress ARE to blame, including the senator from Kentucky. They have no qualms about spending OVER $800 billion to save fiscally irresponsible banks and automobile companies that run for-profit. They let the companies receiving that money spend it on ridiculous executive bonuses. Congress rarely votes down a pay raise for themselves, but they can't be bothered to actually fix Medicare. It's bad enough that the best they have done for the past few years is little more than an extension of current rates and stop-gap measures with hardly an adjustment for inflation. This problem should have been fixed years ago, and the fact that it isn't well addressed in the current health care bill sitting in Congress is pathetic.

Before you make judgement on Senator Bunning, you should read the entire bill. The bill is HR 4691 sponsored by Senator Rangel of NY. This $10 billion bill has only $1 billion for medicare which only delays the doctor cuts until April 1st 2010.The $9 billion is to extend unemployment,extend Cobra,highway repairs,etc.I am a doctor but I'm also an American. This country is broke. Our President and our Congress passed a stimulus package a year ago in which there are $400 billion not used. So far I have not been stimulated.Senator Bunning and others are requesting the use of these funds for medicare and not to increase our deficit. This makes sense.If you don't investigate the news you will never know the truth. Tort reform ,health insurance company regulations(25% of premiums dollars are used for marketing)and allowing doc- tors to police their unethical peers may fix healthcare.If I removed malpractice associated expenses and billing related expenses from my practice I could charge 30% of todays fees and retain a greater net. Do the math.

Senator Bunning reportedly has missed numerous votes that he should have participated in all along because he didn't show up to work he is paid by taxpayers to do. He's been caught sleeping during lawmaking sessions. When he found out Judge Ginsberg had cancer, he publicly said he thought she'd be dead in a year, and was forced to apologize. His own party is requiring that he retire, as he no longer has supporters. No judgement here, just detailing reported facts. Judgement wise: he is known as "bat-sh*t crazy" by those in Washington who have dealt with him. Yes, tort reform is necessary, as is health insurance reform. Medicare advantage spending to fund insurance executive waste and abuse must be stopped cold. Fraud must have harsher penalties, and out of the ordinary claims must be more closely scrutinized. (I know a doctor in Texas that was told by the Feds that somebody fradulently submitted 2 million$ worth of claims on his number out of Florida. How stupid were they to pay Florida claims for a provider with a Texas address?)
Some doctors on already tight margings can't take this cut, and the ones that have over 30% of their business in elderly patients can't afford to get out of Medicare.
This was a bad move, plain and simple.

please stop the nedicare 21% cut. As a health care worker I am concerned that Medicare patients will no longer get the care that they need because doctors will be forced to make cut back in order to balance the loss. That means my job is at risk as a Medical Assistant in a family practice setting. Please we care about our patients.!!!!!Concerned health care worker!!!

How about those of us who have some savings and a fixed income. Does this mean we're going to have to use all our savings to pay what the gov't won't?

I pay my medicare premiums on time and have extra insurance. I thought this would take care of my
dr's bills just about entirely.

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