Part B Insider (Multispecialty) Coding Alert

Published on Mon May 26, 2008 PDF

Veto-proof House vote awaits Senate response

With just a week left before Medicare providers face a 10.6 percent pay cut, all eyes are on the U.S. Senate to protect your payments.

After the Senate failed to vote on a Medicare package last week, the House passed its own version--the Medicare Improvements for Patients and Providers Act (H.R. 6331)--on June 24.

In addition to halting the July 1 rate cut, the legislation would continue the 0.5 percent boost that you received last January and would increase  the conversion factor an additional 1.1 percent for 2009.

But the rate cut may still happen if the Senate doesn't vote favorably. Because the House bill relies mainly on Medicare Advantage plan cuts to fund the physician payment boost and other provisions, the Senate must pass companion legislation by a veto-proof majority to overcome the threatened presidential veto.

Record numbers of House Republicans sided against President Bush by voting for the bill 355-59.

-This is a reasonable compromise that makes modest, but necessary, improvements to Medicare,- said Rep. Pete Stark (D-Calif.), chair of the House Ways and Means Health Subcommittee, after the June 24 House vote. -There is no reason that the Senate can't have a similarly bipartisan vote and send this to the President for his signature this week.-

At press time, the Senate was expected to vote on the legislation by June 27. If it passes, the President could sign it into law before July 1.

Carriers will have to comply: If the bill becomes law, carriers will have to adjust their payment formulas so your payments won't be slashed by 10.6 percent. Some practices, however, worry that their payers will start reimbursing them at a lower rate that includes the 10.6 percent cut immediately after midnight on July 1.

At this point, whether your carrier will hold your payments until the bill is signed, offer a retroactive payment boost after the bill is signed or institute another method is unclear, says Quin Buechner, MS, M. Div, ACS-FP/GI/PEDS, CPC, CCP, CMSCS of ProActive Consultants in Cumberland,Wis.