Medicare Physician Payment Cuts Remain in Place — Take Action Now!

CMS tells contractors to hold claims containing services paid under the MPFS for the first 10 business days of April 2010 — contact your legislators today to urge a permanent solution!

Take Action! Your call is necessary to urge Congress towards a permanent solution to the SGR that fairly and accurately reimburses physicians for the services they provide to Medicare beneficiaries. Contact your Legislators’ state or district office using the Alliance of Specialty Medicine's toll-free Grassroots Hotline at 1 (866) 899-4088. (When asked for your 4-digit specialty code, enter 6969)

During the week of March 22-26, 2010, the U.S. Senate debated HR 4851, which includes a 30-day extension of numerous programs such as COBRA benefits, unemployment insurance benefits as well as an extension to the current Medicare physician payment rates. The U.S. House of Representatives approved this bill earlier this month.

Sen. Tom Coburn (R-OK) objected to the bill’s consideration in the Senate on the basis that it should not be considered emergency spending that would be exempt from budgetary offsets. As a result of Congress’ failure to act before leaving Washington for spring recess, Medicare physician reimbursements will be cut by 21.3 percent beginning Thursday, April 1, 2010.

The Center for Medicare and Medicaid Services (CMS) announced on March 26 that the Agency has instructed its contractors to hold claims containing services paid under the Medicare Physician Fee Schedule for the first 10 business days of April in the event that Congress acts in early April to avert the cuts. This hold will only affect claims with dates of service April 1, 2010, and forward.

According to CMS, the hold should have minimum impact on provider cash flow because, under the current law, clean electronic claims are not paid any earlier than 14 calendar days (29 for paper claims) after the date of receipt.

There have been reports that the Senate will move to postpone cuts by another 30-days following their return on April 12. For years, Congress has provided temporary fixes to the Sustainable Growth Rate (SGR), which only further bankrupts the Medicare system. Short term fixes do nothing to address the underlying problems of the SGR that place patient access to specialty care at risk.

The Society is concerned with another short-term “fix”, and will continue its efforts to ensure enactment of a permanent solution to the SGR that fairly and accurately reimburses physicians for the services they provide to Medicare beneficiaries. Your call is necessary to urge Congress to repeal this flawed payment system and to protect physicians and Medicare beneficiaries.

Protect Medicare patients’ access to specialty care! Take Advantage of spring recess to contact your Legislators’ state or district office using the Alliance of Specialty Medicine's toll-free Grassroots Hotline at 1 (866) 899-4088. When asked for your 4-digit specialty code, enter 6969.

When you speak with your legislators, you may want to tell them:

• "As a physician and constituent, I am disappointed that Congress continues to threaten Medicare beneficiaries’ access to their physicians by failing to provide a long term solution to Medicare physician reimbursement under the sustainable growth rate (SGR) formula."
• "Reforming the health care system should include reforming this flawed formula."
• Mention the changes you will be required to make in your practice if the cuts go into effect.