President Signs Bill to Fix the SGR for Six Months

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  • June 25, 2010
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President Obama signed June 25 a bill that temporarily rescinds the 21.3 percent Medicare pay cut for physicians that went into effect June 1 and replaces it with a 2.2 percent update through Nov. 30. The best part for coders is that claims submitted during June before this bill was signed will automatically be reprocessed at the new rate.
According to the Centers for Medicare & Medicaid Services (CMS), the new law establishes 2.2 percent update to the Medicare Physician Fee Schedule (MPFS) payment rates from June 1 through Nov. 30, 2010.  Medicare contractors have been instructed by CMS to discontinue processing claims at the negative update rates and to temporarily hold all claims after June 1 until the new rates are tested. CMS says it expects processing will resume by July 1.
A CMS e-mail issued to contractors June 25 said, “Claims containing June 2010 date of service which have been paid at the negative update rates will be reprocessed as soon as possible.”
A negative 23 percent update to the conversion factor will apply Dec. 1 unless Congress acts yet again to delay the Medicare pay cut for physicians or, daresay, resolve the problem once and for all.
The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 also establishes a data match between the Centers for Medicare & Medicaid Services (CMS) and the Internal Revenue Service (IRS) to allow CMS to identify providers with a history of tax fraud.
As written in the bill, the IRS may disclose to CMS tax return information with respect to a taxpayer who has applied to enroll, or reenroll, as a provider of services or supplier under the Medicare program. Information that may be shared includes:

  • the taxpayer identity information with respect to such taxpayer
  • the amount of the delinquent tax debt owed by that taxpayer; and
  • the taxable year to which the delinquent tax debt pertains.

The bill also includes clarification of the three-day payment window, and extends the period for single-employer defined benefit plans to amortize certain shortfall amortization bases.

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