Physician Pay Cut Effective June 1

As the Senate continues to debate over how to pay for legislation that would at least temporarily prevent a 21.3 percent cut in Medicare physician payments, the hold the Centers for Medicare & Medicaid Services (CMS) put on claims expired June 17. Beginning June 18, contractors may process claims for services furnished on or after June 1 at the reduced rate.

According to an American Medical Association (AMA) eVoice Alert, however, CMS assumes Congress will ultimately pass the American Jobs and Closing Tax Loopholes Act (tax extenders bill) and make the physician pay fix retroactive to June 1.

Once Congress acts to avert the cut, the AMA says, contractors will automatically reprocess claims when a submitted charge is higher than the new rate. If a submitted charge is lower than the new rate, the physician should call the contractor.

The question is: When will Congress pass the legislation (HR 4213) and what will the new rate be?

Nobody knows the answer to either question at this point. From the moment the bill passed through the U.S. House of Representatives on May 28, the Senate has hacked away at provisions in an attempt to make it more affordable to tax payers.

According to the AMA, an amendment Senate Finance Committee Chairman Max Baucus (D-Mont.) introduced that would have afforded a 19-month reprieve from the scheduled Medicare payment cuts by providing a 2.2 percent update for the remainder of 2010 and an additional 1.0 percent update in 2011 was defeated. In a second substitute amendment, the Sustainable Growth Rate (SGR) relief provision was scaled back to a six-month, 2.2 percent update that would expire Nov. 30, 2010, after which the 21.3 percent cut originally scheduled for 2010 would take effect.

According to a BNA Daily Tax report, “Moderate senators from both parties said June 17 that Senate Finance Committee Chairman Max Baucus’s (D-Mont.) scaled-back version of the Senate’s tax extenders bill is still too expensive to get their support, leaving Senate leaders short of the 60 votes needed to advance the legislation.”

“I want to see it all offset, except for those things that are through an emergency,” Sen. Ben Nelson (D-Neb.) said, adding that an extension of unemployment insurance benefits and federal Medicaid funding to states—the only two provisions in the substitute that are not paid for—do not qualify as emergencies.

To which Baucus replied: “There are 100 senators. We need 60. There are lots of combinations. We’re working hard … We’ll get 60 votes. I can’t say exactly when, but we’ll get 60 votes.”

When and if that day comes, the revised bill will then have to be sent back to the U.S. House of Representatives for passage.

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6 Responses to “Physician Pay Cut Effective June 1”

  1. Brenda McChargue says:

    This is going to create a billing nightmare for all doctors and billing companies. This will cause double billing and posting. I would encourage our congress to avert the cut in Medicare.

  2. J W Wagner says:

    I sugest that if we cut medicare pay to Doctors that we cut Rep. Senate and congress pay also.

  3. Philip W. Hill says:

    Of course, this has all been a posturing to pretend that the “Health Care Reform Legislation” was coming in at a lower than actual cost. By the time all the “cuts” have been restored, the tax increase to cover it will be enormous and the government will own more of our rights and more of the intimate details of our lives. Jobs will disappear and more doctors will give up their practices. So much for the great American dream and so much for our government’s promises especiallt to the servicemen.

  4. Dan Lingenfelter says:

    Apparently the incumbent congress has forgotten about this being a country “of the people, for the people, and by the people!!!~Our 2 party system is a total failure…ALL of the incuments should be voted out as terms expire..or better yet..Impeach the whole bunch andthen start over!!! I am a retired military man, age 77 with multiple medical issues…why I fought the 2 wars I did (Korea/Vietnam) I am begining to wonder why????….I have other solutions but don not need a visit from hundreds of people wearing trenchcoats!!!! nuff said.

  5. Robert F. Anderson, Jr. says:

    I fail to see how our Senate and Congress can afford to give themselves nice pay raises but can’t find the money or the guts to fix Medicare and T F L payments.
    We have an oportunity to get rid of every person in the House of Representatives this November and 1/3 of the Senate. Do the American People have the guts to do it? This is one citizen who is voting against any incumbent no matter how great they may have been.

  6. Pia M. Berks says:

    Not only have the insurance companies cut reimbursement over the past 15 years, but also the Medicaid Program and now Medicare. The malpractice premiums are driving physicians out of business. The doctors of this country are making less and less money while having to work more and more hours. They go to school until they are in their 40ties, only to work nights and weekends for peanuts and often for free. Why would anyone even want to be a doctor anymore. By the time the baby boomer are in their 60ties and a huge populations is in need of medical care, there will be no doctors to treat them. They will wait for appointments for a specialist for weeks and months only to be treated by a P.A. or some other cheaper physician supplement provider. By then all the private doctor’s offices are going to be owned by the insurance companies, such as Kaiser and other corporate giants and medicine will no longer be a science to help the people, but a business that is all about the bottom line.

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