Stop the Medicare Meltdown

Senate Votes, House Leaves, Medicare Fees Drop Jun 21. 2010 | Comments (1)

Medicare payments to physicians dropped 21.3 percent June 18, on claims for service on or after June 1, as continuing congressional dysfunction failed to stop the cut from taking effect.

"Washington obviously doesn't realize the damage they're doing to our practices and our patients," said TMA President Susan Rudd Bailey, MD. "The blame extends to both parties, to the House and the Senate, and to the White House. Shame on all of you."

Even though the Senate approved a deal earlier today stopping the cuts and raising fees 2.2 percent until Nov. 30, there was no hope of avoiding a temporary cut as the House of Representatives was out on Friday and is not scheduled to resume voting until Tuesday. Both chambers have to approve the same proposal. The House voted last month to stop the cut and replace it with a 19-month Band-Aid, consisting of a 2.2-percent increase for the rest of the year and a 1-percent increase for 2011. That was part of a larger bill extending federal unemployment benefits.

While Congress continued to play political games with the health care of senior citizens and military families, the hold the Centers for Medicare & Medicaid Services (CMS) placed on physicians' claims expired. CMS has now directed TrailBlazer Health Enterprises and other Medicare contractors to begin processing claims dated June 1 and later under the new rates on a first-in, first-out basis.

According to an American Medical Association statement, once the House approves the bill and President Obama signs it, CMS will retroactively adjust any June claims that have been paid.

"Congress continues to debate the elimination of the negative update that took effect June 1, 2010," said a CMS advisory. "The CMS is hopeful that congressional action will be taken to avert the negative update and will continue to monitor those actions. If Congress changes the negative update currently in effect, CMS is prepared to act expeditiously to make the appropriate changes to Medicare claims-processing systems."