Docs Left in Waiting Room on Medicare Cuts

June 18, 2010

If you were hoping for a resolution to the months-long tug-of-war over Medicare reimbursements in Washington, D.C., the end seems nowhere in sight.

If you were hoping for a resolution to the months-long tug-of-war over Medicare reimbursements in Washington, D.C., the end seems nowhere in sight.

After a week of deadlock in the U.S. Senate, the scheduled 21 percent cut to your reimbursement rate is set to take effect and the end of the day could bring with it a new reality. With a 19-month delay in the cut defeated in the Senate, a new, six-month delay also failed to win a majority of support from lawmakers.

CMS again directed contractors to hold claims for service paid under the 2010 Medicare Physician Fee Schedule through today, Friday, June 18, with the hopes that Congress takes some kind of step forward. But the clock is ticking and when you enter your office on Monday, you could face either a new Medicare reality or a longer wait for Congress to take action.

New AMA President Cecil B. Wilson said in a statement that Congress, “has broken its promise to America’s seniors and military families.” He noted the 17-day lapse in Congress taking action dating back to the beginning of the month, when the Continuing Extension Act of 2010 expanded the zero percent update in the 2010 MPFS delayed action until May 31. When that deadline expired, CMS issued its claims delay.

The AMA has been sending congressional leaders white lab coats from its member physicians to remind them of the need for a long-term solution rather than a short-term stopgap measure.

Wilson said the 21 percent cut will hurt both seniors and physicians, “forced to make difficult practice changes to keep their practice doors open,” symbolizing the frustration of many. He, like others, has called for the end to short-term extensions, dubbed a “Band-Aid,” by the new association leader, and instead, “a problem that needs urgent surgery.”

The AMA said that CMS remains hopeful that congressional leaders will pass a measure retroactive to the June 1 deadline. The agency, along with the Office of the Inspector General, are close to releasing a document to waive patient co-pay requirements for situations such as the retroactive increases that were made to the geographic practice cost index increases, according to the AMA.

President Barack Obama, in his weekly radio address to the nation June 12, has urged Republicans in the Senate to bypass political theater in order to avoid hurting America’s seniors and their doctors. As Senate Republicans continue to argue that the tax extenders bill will further contribute to the bankruptcy of our nation, the president in his address acknowledged, “simply kicking these cuts down the road another year is not a long-term solution.”

So how is this delay impacting you? Are patients covered by Medicaid calling with questions? Has your practice prepared for further inaction by Congress?