Physicians' Pay Rates in Limbo This Week

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  • June 1, 2010
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The Continuing Extension Act of 2010, which extended the zero percent update to the 2010 Medicare Physician Fee Schedule (MPFS), expired May 31. Legislation on the table that would prevent a 21 percent pay cut to physicians from going into effect June 1 was approved by the U.S. House of Representatives (215-204) on May 28. The Senate, however, did not take up the bill before all of Congress recessed for a week-long holiday.
Foreseeing this delay, the Centers for Medicare & Medicaid Services (CMS) instructed its contractors to hold claims containing services paid under the MPFS (including anesthesia services) for the first 10 business days of June. This hold affects MPFS claims with dates of service June 1, 2010 and later.

The 10-day hold will give Congress about a week to volley the American Jobs and Closing Tax Loopholes Act (HR 4213), or Extenders bill, before passing the final version.
The current version of the bill the Senate will take up when it reconvenes June 7 provides, among other things, a 2.2 percent update to physician pay rates for the rest of 2010 and an additional 1 percent update for 2011.
Hospitals do not fair so well, however. The American Hospital Association (AHA) and other national hospital groups have expressed “serious concern” over a change to Medicare’s “72-Hour Rule” that would prevent hospitals from submitting separate Medicare reimbursement claims for inpatient care and outpatient therapeutic care provided within three days of a hospital admission. According to an May 28 report, this change would result in payment reductions to hospitals amounting to approximately $4 billion.
See HR 4213 for the complete text pertaining to health-related provisions in this proposed bill.

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