21 percent Medicare cut postponed for 31 days

3 March 2010

Late Tuesday, Mar. 2, the U.S. Senate passed HR 4691, the “Temporary Extension Act of 2010,” which will extend 2009 Medicare physician payments rates to Apr. 1, 2010. The U.S. House of Representatives had passed this legislation last week and President Obama immediately signed the measure into law. In addition to extending several expiring provisions including COBRA and unemployment benefits, the legislation reverses the 21.2 percent cut to physician Medicare payments that went into effect Mar. 1. 

The Medical Society of Virginia (MSV) and MSV Alliance leadership – including Daniel Carey, M.D., Thomas Eppes, M.D., Rufus Phillips, Gail Arthur, M.D., Krista Crawford-Mathis, and Natalie Rude – met with Sen. Mark Warner and representatives from the office of Sen. Jim Webb earlier this week to express MSV’s desire for a permanent fix to the flawed sustainable growth rate (SGR) formula that determines Medicare reimbursement. Both Sen. Warner and Sen. Webb voted in favor of HR 4691.

Frequently Asked Questions

How will claims for dates of service beginning Mar. 1, 2010 be processed? 
The Centers for Medicare & Medicaid Services (CMS) has put in place safeguards to avoid disruption in payment of claims for physicians, non-physician practitioners, and other providers of services paid under the Medicare physician fee schedule. In anticipation of legislative action, CMS previously instructed its contractors to hold claims containing services paid under the Medicare Physician Fee Schedule (MPFS) with dates of service beginning Mar. 1, 2010. Effective immediately, claims with dates of service Mar. 1 and later which were being held by Medicare contractors will now be released for processing and payment. Please note that the earlier hold should not impact 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. Now that an extension has passed, these claims will be paid using Medicare’s 2009 physician fee schedule.

Can I still change my Medicare participation status?
Due to the uncertainty surrounding the 2010 Medicare fee schedule, physicians have until Mar. 17 to change their Medicare participation or non-participation status in 2010. The AMA has prepared the guide Medicare Participation Options for Physicians (PDF) to help physicians make this decision.

What is Congress planning to do regarding a permanent SGR fix?
Discussions are still underway in the U.S. House and Senate on the next steps that will be taken to address the Medicare payment crisis. Proposals are being circulated that would implement still another short-term patch to the SGR formula, including proposals that would postpone cuts for 90 days, 7 months, or through the end of 2010. MSV continues to advocate for permanent repeal of the SGR, rather than repeating the pattern of short-term remedies that serve to make future payment cuts more severe and increase the cost of permanent Medicare payment reform.

How can I get my Medicare patients involved in advocating against these cuts?
The American Medical Association (AMA) has developed the Patients’ Action Network to encourage consumer advocacy on this issue. Click here for advocate resources, including patient grassroots alerts.

Didn't you also contact me recently about pending Medicaid payment cuts?
Yes. The Virginia General Assembly is in the process of developing the commonwealth's budget for fiscal years 2011-2012. State legislators have proposed cuts to physician Medicaid payments in order to balance the state budget. MSV appreciates the Virginia physicians who sent messages to their delegates and state senators explaining how Medicaid payment cuts would hurt patients and impact your practices – over 900 messages have been sent to legislators to date.