21.2 Percent Medicare Cut Averted

Senate Acts to Reverse Deep Reductions in Physician Payments

March 03, 2010 11:40 am James Arvantes

The Senate has passed a one-month extension of the Medicare physician payment rate, thus reversing a 21.2 percent payment reduction that took effect based on the sustainable growth rate, or SGR, formula on March 1.

On March 2, the Senate approved a House-passed bill, H.R. 4691, that provides a 30-day extension for several programs, including the Medicare physician payment rate. President Obama signed the measure into law the same day.

"We are pleased that our patients and members will not have to endure the effects of a 21.2 percent reduction in Medicare payment," said AAFP President Lori Heim, M.D., of Vass, N.C., in an interview with AAFP News Now.

Heim said, however, it is "unconscionable" that the Senate was unable to pass a payment update before the Medicare cut actually went into effect on March 1.

The enactment of H.R. 4691 means that Congress will have time to work on a longer-term solution to the Medicare payment cuts for 2010 called for by the SGR. The Senate is working on a bill that would extend the current Medicare payment rate until Oct. 1.

CMS Releases Physician Payment Information

According to a March 3 e-mail from CMS to national professional medical organizations, physician Medicare claims with dates of service beginning on March 1 and later that were being held by Medicare contractors now will be released for processing and payment. As always, clean electronic claims cannot be paid before 14 calendar days after the date they are received by Medicare contractors. Clean paper claims are held for 29 days.

However, Heim and AAFP members are calling on Congress to enact a permanent SGR payment fix. The current SGR system has created an unstable payment environment for physicians and their patients, said Heim. "Family physicians need to know that their practices are secure. Letting the (payment update) lapse and then only providing a 30-day patch once again highlights that physician payment is being held hostage by Congress," Heim emphasized.

AAFP members have vigorously lodged their objections to the cuts with their congressional representatives. A recent Action Alert from the Academy resulted in members sending more than 2,200 messages to Congress in only two and one-half days. Since Feb. 1, AAFP members have sent more than 6,000 messages to Congress regarding the Medicare payment cut.