And so it begins ... Medicare claims pay out today, fees cut 21 percent

With half of the year behind us, the Medicare Physician Fee Schedule for 2010 still hangs in limbo. This afternoon, the Senate voted to delay the cut another six months, but the cut is still in place until the U.S. House of Representatives acts.

In response to Congressional inertia, CMS had issued guidance to the Medicare contractors on June 14 to continue holding claims with dates of service June 1 or later until Friday, June 18. So starting today, your claims for dates of service June 1 or later will be paid at the 21-percent reduced rate – and likely reprocessed later if Congress makes an updated fee schedule retroactive to June 1.

Hopefully the Congressional action will take place next week but in the meantime, your practice must determine if and how this affects your day-to-day operations. If you have a significant Medicare and Tricare patient population, you may need to assess your options for maintaining a workable cash flow and perhaps making some temporary cut backs in expenses:

• Are there any planned purchases that can be delayed?
• Can you schedule more procedures and ancillary services to offset the lost revenue?
• Would a push to clean-up outstanding accounts receivables make a difference?
• Can you limit the number of non-urgent Medicare and Tricare patients seen in the next few weeks to bring in more patients whose plans pay higher fees?

These disruptive and disheartening delays take away from your practice's ability to focus on quality care and waste tax dollars to pay for the reprocessing of claims due to untimely legislation and the unwillingness of our Congress to develop a long-term solution to this broken payment methodology. Help keep this issue in front of the Congressional representatives through AAFP Speak Out. Download and share these information pieces about the broken Medicare physician payment system by placing copies in your waiting and exam rooms.

Stay tuned. Good, bad, or more of the same, we'll keep the reports coming. In the meantime, keep in mind this quote often attributed to Mark Twain: "No man's life, liberty, or property is safe while the legislature is in session." Things haven't changed much in 150 years, have they?

Posted on Jun 18, 2010 by Cindy Hughes