Action Needed to Prevent 21.2% Physician Fee Cut Delayed Again by U.S. Congress

The U.S. Congress pushed back a 21.2 percent Medicare physician fee cut until June 1, 2010, this week as part of a larger bill aimed at extending benefits such as unemployment and COBRA, according to an article at www.medscape.com.

This is the third delay this year, with the Centers for Medicare and Medicaid Services announcing earlier that it would either reprocess claims submitted at the higher former rate or base payment on the lower pay schedule from April 1, 2010, when the cut was supposed to take effect.

“Claims with submitted charges at or above the higher rates will be automatically reprocessed without further action,” the CMS stated. “Providers have the option of holding their affected claims until the legislative landscape becomes clearer.”

Another two-month delay allows Congress to continue working on a long-term fix of the sustainable growth rate (SGR) formula, which bases spending on physician services partly on gross domestic product growth. To recoup costs when spending tops that target, Medicare is tasked with decreasing physician pay to recoup the difference, according to the Medscape article.

To encourage Congress to repeal the SGR and devise a more equitable rate increase schedule, SROA members are asked to contact their representatives and senators. For more information on these bills, go to www.medscape.com or www.Thomas.gov, the Library of Congress Web site.