Congress Fails to Prevent April 1 Cut in Medicare Physician Payments

Congress has once again failed to act in a in order to stop the 21.3 percent Medicare physician payment cut. Senator Tom Coburn (R-OK) voiced objections to H.R. 4851, stating that it was not emergency spending and therefore was not exempt from budgetary offsets. Congress has now adjourned for its two-week spring recess without taking action to stop the 21.3 percent cut from taking effect. It is possible that the Senate will hold a cloture vote after the recess, which, if supported by 60 Senators, will allow a vote to occur on the legislation.

The Centers for Medicare & Medicaid Services (CMS) is working with Congress, health care providers, and the beneficiary community to avoid disruption in the delivery of health care services and payment of claims for physicians, non-physician practitioners, and other providers of services paid under the Medicare Physician Fee Schedule (MPFS). As you are aware, the Temporary Extension Act of 2010, enacted on March 2, 2010, extended the zero percent (0%) update to the 2010 MPFS through March 31, 2010.

CMS believes Congress is working to avert the negative update that will take effect April 1. Consequently, CMS has instructed its contractors to hold claims containing services paid under the MPFS (including anesthesia services) for the first 10 business days of April. This hold will only affect claims with dates of service April 1, 2010, and forward. In addition, the hold should have minimum impact on provider cash flow because, under the current law, clean electronic claims are not paid any sooner than 14 calendar days (29 for paper claims) after the date of receipt.

The AMCNO urges our members to contact their Representatives and Senators during their spring break – track them down and hold them accountable for their inability to do what they know is right for patients and their physicians: passing legislation to repeal Medicare’s sustainable growth rate formula once and for all. Here are their local office phone numbers – call them today and tell them they must do what is right for physicians and their patients.

Sen. Sherrod Brown – (216) 522-7272

Sen. George Voinovich - (216) 522-7095

Rep. Dennis Kucinich - (216) 228-8850

Rep. Marcia Fudge - (216) 522-4900

Rep. Betty Sutton - (330) 865-8450

Rep. Steve LaTourette - (440) 352-3939