Medicare physician pay cut delayed until Nov. 30

The House of Representatives voted 417-1 Thursday night to pass a bill that delays a 21% cut in Medicare physician payments and raises payments 2.2% until Nov. 30.

President Barack Obama signed the bill into law this morning. The Senate had passed the bill on June 18.

The measure is retroactive to June 1, the date the payment cut took effect. In late May, the House passed legislation to delay the cut by 19 months; the measure failed to come up for a vote in the Senate before Memorial Day.

CMS has directed Medicare claims administration contractors to discontinue processing claims at the negative update rates and temporarily hold all claims for services rendered after June 1, until the 2.2% update rates are tested and programmed into claims processing systems, according to a legislative alert issued by the American Society of Cataract and Refractive Surgery.

Processing of claims at the new rate is expected to begin no later than July 1, the ASCRS statement said.

The physician payment cut stems from the sustainable growth rate (SGR), a key factor in annual Medicare physician payment updates. The SGR has resulted in a series of negative payment updates for several years.

The American Medical Association called on Congress to alter or repeal the SGR.

“The 6-month Medicare patch Congress passed today is a very temporary reprieve for seniors and baby boomers who rely on the promise of Medicare,” Cecil B. Wilson, MD, president of the AMA, said in a statement issued last night. “Delaying the problem is not a solution. It doesn’t solve the Medicare mess Congress has created with a long series of short-term Medicare patches over the last decade — including four to avert the 2010 cut alone.”

The physician payment cut may reach 23% in December and 30% in January if the SGR is not eliminated or replaced by then, Wilson said.

“Congress is playing a dangerous game of Russian roulette with seniors’ health care,” he said. “Sick patients can’t wait. Congress must replace the broken payment system before the damage is done and cannot be reversed. The baby boomers begin entering Medicare in 6 months, and if the physician payment problem isn’t fixed, these new Medicare patients won’t be able to find a doctor to treat them.”

About one in five physicians is limiting the number of Medicare patients treated because of uncertainty in Medicare payments, Wilson said.