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Tuesday Mar 31, 2015

March Madness Goes Into Overtime

Last week, in an overwhelming display of bipartisanship, the House of Representatives approved the Medicare Access and CHIP Reauthorization Act (H.R. 2) by a vote of 392-37. After 12 years of temporary patches, the House stated that the failed sustainable growth rate (SGR) formula should be eliminated from the Medicare program.

The AAFP issued a statement that praised the House for its overwhelming support of H.R. 2 and called on the Senate to follow the House’s lead and pass the legislation prior to adjourning for the annual spring recess.  

Upon House approval, the AAFP swiftly informed members through an AAFP News article and direct emails to our state chapters and members regarding the House vote and called for aggressive advocacy targeted at the Senate. AAFP members and our state chapters answered the bell and made several phone calls to key Senate offices urging immediate action. AAFP President Robert Wergin, M.D., was in Washington when the House voted on March 26 and personally called several Senators during the course of the day, urging them to pass H.R. 2 prior to adjourning.

Unfortunately, the Senate didn’t share the House's sense of urgency and failed to consider the legislation prior to adjourning. The Senate is scheduled to return April 13. In a positive sign, Senate Majority Leader Mitch McConnell, R-Ky., said before the Senate adjourned on March 27, “It is encouraging this [H.R. 2] passed the House with such a large bipartisan majority, and I want to assure we’ll move to it very quickly when we get back. … I think there is every reason to believe it’s going to pass the Senate by a very large majority.”

In a statement the Academy expressed its disappointment that the Senate failed to follow the House’s lead and protect Medicare patients and children’s access to care prior to adjourning. We called on senators to promptly approve H.R. 2 upon their return, thus preventing disruptions in care for millions of Medicare beneficiaries.

The Senate’s failure to act on HR 2 prior to adjourning means that the 21 percent cut scheduled for April 1 will take effect. As a result, all services provided by Medicare participating physicians on or after Wednesday, April 1 – continuing until the Senate passes HR 2 and the law is enacted into law by the President – will be subject to the 21 percent cut. CMS has instructed its carriers to “hold,” for 10 business days, any claims for services provided on April 1 and beyond, until legislation can be passed and signed into law that reverses the 21 percent cut. The 10-day hold means that April claims will be held through Tuesday, April 14. Under current law, no claims can be paid sooner than 14 calendar days from their receipt, so this hold will have a minimal impact on Medicare remittance in the short-term.  

However, the claims hold period does complicate billing for co-payments and claims reconciliation. Family Practice Management has created a resource, “Preparing for a Medicare Fee Cut,” that is designed to help you and your practice prepare for any reductions in revenue that may occur as a result of the cut.

Since it is spring, I am going to offer a golf analogy. It is often stated that the Masters is “won or lost on the back nine on Sunday afternoon.”  Well, my friends, it’s Sunday, and we are on the back nine of the SGR issue. The only remaining question is whether we win or lose. I want to win, and I believe you do as well. The AAFP has engaged you on this issue multiple times during the past two months, and you have responded. The advocacy engagement of our members is one of the reasons 392 members of the House voted to repeal the SGR. We thank you for all of your great work, but we need more.

Between today and April 13 you need to communicate your strong support for the House-passed  Medicare Access and CHIP Reauthorization Act (HR 2) to your senators. Please visit our Speak Out page, and send a letter to your Senators. After you send a letter, call your Senators. The AAFP has a toll-free phone system that allows you to do this conveniently. Simply call (866) 629-5269, provide your state, and you will be connected to your senate offices. Once connected, simply tell them you are a family physician practicing in their state, and you urge them to vote yes on HR 2 when it is considered by the Senate. That’s it – simple. Call them every day. Tell your colleagues to call. Tell your patients to call.  

The AAFP has worked tirelessly on this issue for more than a decade, and with your continued help, we can finally repeal the flawed SGR formula. Victory is in sight, but we must stay focused and engaged for these final days.

Posted at 08:00AM Mar 31, 2015 by Shawn Martin

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ABOUT THE AUTHOR



Shawn Martin, AAFP Senior Vice President of Advocacy, Practice Advancement and Policy.

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The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.