Congress Votes to Stop Physician Pay Cut

Congress has passed legislation to counteract the Sustainable Growth Rate (SGR) formula that would have reduced Medicare physician reimbursement rates. The U.S. House of Representatives voted 409-2 in favor, Dec. 9, and the Senate voted by unanimous consent, Dec. 8, for the Medicare and Medicaid Extenders Act of 2010 (HR 4994). The bill was presented to President Obama Dec. 10 for signing. If and when the president signs the bill, it will postpone the 25 percent pay cut to physicians until Jan. 1, 2012.

Update: President Obama signed the Medicare and Medicaid Extenders Act of 2010 on Dec. 15.

The bill reverses the 25 percent reduction to Medicare payment rates set to take effect Jan. 1, 2011 and extends current Medicare payment rates through Dec. 31. 2011.

This bill also extends through Dec. 31, 2011:

  • The therapy caps exception process
  • The ability of independent labs to receive direct payments for the technical component for certain pathology services
  • Increased Medicare rates for ambulance services, including in super rural areas
  • The 5 percent increase in payments for certain Medicare mental health services
  • Medicare Modernization Act (MMA) section 508 reclassifications
  • The existing 1.0 geographic adjustment floor on the physician work index
  • and other provisions.

A summary of the Medicare and Medicaid Extenders Act of 2010 on the U.S. Senate Committee of Finance website provides a complete list of provisions.

Some Legislative Background

In case you lost track, this bill, is the fifth legislative action this year alone to forestall a negative update to physicians paid under the Medicare Physician Fee Schedule (MPFS).

On Nov. 30, 2010, President Obama signed the Physician Payment and Therapy Relief Act of 2010 to postpone a 21.3 percent negative update to Medicare payments and extend the current 2.2 percent update from Dec. 1, 2010 through Dec. 31, 2010.

On June 25, 2010, the president signed the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, which put off the 21.3 percent pay cut and put in place a 2.2 percent update to Medicare payments, effective June 1, 2010 through Nov. 30, 2010.

On April 15, 2010, the president signed the Continuing Extension Act of 2010 to postpone the 21.3 percent Medicare pay cut and extend a zero percent update to physicians paid under the MPFS beginning April 1, 2010 and expiring May 31, 2010.

On March 2, 2010, the president signed the Temporary Extension Act of 2010 to extend a provision in the Defense Appropriation Act of 2009, which postponed the 21.3 percent Medicare pay cut, from Jan. 1, 2010 through March 31, 2010.

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3 Responses to “Congress Votes to Stop Physician Pay Cut”

  1. Susan Logan says:

    I am glad someone is looking out for the care of the elderly even if it is only a temporary fix.
    With the R in, it will most likely disappear.

  2. sharene says:

    see report on the anticipated medicare increase

  3. Lisa Goldman says:

    So I am correct to assume that the current 2010 fee schedule will be the correct prices to use in 2011? We are non-par so we are allowed to charge the limiting amount and we follow that to the letter.

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