Senate fails to meet deadline for Medicare physician payment cut

CMS will briefly delay cuts for Medicare physician reimbursement.

On Friday, the House of Representatives voted 245-171 to pass an extension of the 19-month sustainable growth rate provision, which would delay the 21.1% reduction in Medicare physician payments through 2011. However, the Senate adjourned for the Memorial Day recess without voting on the package, leaving the Medicare cut to go into effect today.

Congress will have to stop the cut retroactively when it returns after the recess on Monday.

The Medicare payment cut was originally schedule to take place on Jan. 1. This is the third time since February that the bill has been stalled.

The Centers for Medicare and Medicaid Services has instructed Medicare contractors to hold claims for the first 10 business days in June to allow Congress to complete its action and overturn the scheduled payment cut. Under current law, clean electronic claims are paid no sooner than 14 calendar days after receipt of the claim (29 days for paper claims).

In a statement from the American Medical Association, J. James Rohack, MD, president of the association, said, “Enough is enough: Nine times in eight years Congress has delayed the cut and not fixed the problem.

“The Senate has turned its back on seniors, and America’s physicians are outraged that Congress has deserted patients by failing to address this year’s Medicare cuts before the June 1 deadline. Senators are more interested in heading home for the holiday than in preventing a Medicare meltdown for seniors. Congress needs to buckle down, stop growing the problem, and fix it once and for all to save the Medicare and TRICARE programs for American’s seniors and military families.”

J. Fred Ralton Jr., MD, president of the American College of Physicians, said “Congress’ recurring failure to enact a long-term plan to replace the [sustainable growth rate] will result in bigger cuts and greater budget outlays in the future. Now, Medicare increasingly is viewed as an unstable and unreliable payer of services, with the result that more and more physicians will likely have no choice but to limit how many Medicare and TRICARE patients they can afford to accept in their practices.” – by Jennifer Southall

Who is more delusional: Legislators who think they can continue to spend more than our country earns without bankrupting it or physicians who think that legislators will be able to do so and thus protect physicians' incomes? The laws of economics, like the law of gravity, cannot be ignored. Eventually, economic reality will need to be faced - no matter how painful. What we are seeing with the SGR is only the beginning.

– Richard Dolinar, MD
Senior Fellow in Health Care Policy, Heartland Institute, Chicago

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