Updated June 16, 2010
Senate Debating Temporary Fix for Medicare Physician Payment Cuts
The U.S. Senate has begun debating several potential solutions to avert the 21.3 percent cut, that went into effect on June 1. Senator Max Baucus (D-MT) introduced an amendment which included a 19 month temporary fix identical to the one passed by the House of Representatives on May 27. (See below for more information.) However, this amendment was withdrawn when the motion to waive the Pay Go requirement (which requires that the cost of amendments be fully offset by new revenues) failed to pass by the required 60 votes. The vote was 45-52.
On Thursday, June 17, the Senate will vote on a substitute amendment proposed by Senator John Thune (R-SD) which will provide:
- 2 percent increase for the remaining of 2010
- 2 percent increase for 2011 and 2012
- Cuts to Physician in 2013.
According to the released background documents, this amendment is fully offset, which was not the cases with the amendment proposed by Senator Baucus.
Although the Thune amendment is not expected to pass, any amendment to the Senate bill will require the bill to be sent to the House for approval.
Earlier this week, the Centers for Medicare and Medicaid Services instructed its contractors to hold claims through Thursday, June 17. By law, Medicare contractors will be required to start processing the claims with the 21.3 percent reduction on Friday, June 18.
Updated June 14, 2010
Medicare Contractors to Hold Claims through Thursday, June 17
On Monday, June 14, 2010, the Centers for Medicare and Medicaid Services (CMS) directed its contractors to hold claims for physician services for an additional three days (until Thursday, June 17).
As detailed belowed, the U.S House of Representatives passed a 19 month temporary patch averting the 21.3 percent Medicare physician payment cut, which went into effect on June 1. After its return from the Memorial Day Recess (which ended on June 7), the Senate began its debate on this provision.
On May 27, Medicare contractors were instructed to hold claims for 10 business days for physician services provided on or after June 1 to allow time for Congress to overturn the scheduled cut retroactive to June 1. This holding period is set to expire tomorrow (June 15).
Given the possibility of congressional actions in the next few days, CMS directed its contractors to continue holding claims for physician services until Thursday June 17.
Unless Congress acts in the next three days, Medicare contractors then will begin processing claims with a 21.3 percent reduction on Friday, June 18.
The Heart Rhythm Society's Health Policy staff will continue to monitor the developments on this issue and will provide updates to our members. If you have any questions, please e-mail Isabelle Le Blanc, Coordinator, Legislative Affairs & Health Policy.
Updated June 1, 2010
House Passes Medicare Physician Payment ‘Patch,’ Senate Vote Needed To Block 21.3 Percent Cut
On the evening of Friday, May 28, the U.S. House of Representatives passed H.R. 4213, which temporarily extends several expiring tax provisions through 2010. This 19-month Medicare physician payment patch passed by a 245-171 vote.
Since the Senate had already recessed for the Memorial Day break, it is expected to vote on this measure when it returns from the Memorial Day recess. The earliest this will take place is June 7. It is unclear if the Senate has the votes to pass this bill.
As reported below, the Centers for Medicare & Medicaid Services (CMS) has instructed its contractors to hold all claim processing for physician related services for 10 business days, to provide time for Congress to complete its action and overturn the scheduled cut retroactive to June 1.
May 28, 2010
Congress Fails to Address Medicare Physician Payment Cut Before June 1 Deadline
Congress was unable to address the Medicare physician payment cut before June 1; in response, CMS instructed its contractors to hold claims for physician services for 10 business days.
House and Senate Democratic leaders are working on a new tax extender bill entitled "American Jobs and Closing Tax Loopholes Act" (H.R. 4213), which includes a proposal to avert the 21.3 percent Medicare physician cut scheduled to take into effect June 1, 2010.
Last month, Congress passed a one month patch to avoid the scheduled Medicare physician payment cut; this patch is scheduled to expire on Tuesday June 1.
Democratic leadership was unable to gather enough votes to pass the proposed bill earlier this week due to concerns about its budgetary impact. As a result, "slimmed down" bills were released on Wednesday, May 26, and on Thursday, May 27. With the hope of easing fiscal conservatives' concerns, the House leaders shrank the bill's price tag by approximately $80 billion.
The provision included in this tax extender bill to avert the 21.3 percent cut has been modified (compared to earlier versions that were circulated on Capitol Hill). The current proposal is:
- 2.2 percent positive update through December 2010
- 1 percent positive update for 2011
- for 2012 and thereafter, the system will reverse back to the current system with a 33 percent projected cut
As House leaders are still struggling to get the 218 votes to pass the full bill, they have decided to split up votes on this bill into two parts:
Part I — the extension of unemployment benefits through November and tax extenders
Part II — the 19-month Medicare physician payment fix, as described above.
The House of Representatives is scheduled to vote on the two parts today, which can pass or fail individually. Assuming passage by the House, the Senate, already in recess for Memorial Day, will not vote until the week of June 7.
CMS has already issued instructions to its contractors to hold claims for Medicare physician services provided on or after June 1 for 10 business days, to provide time for Congress to complete its action and overturn the scheduled cut retroactive to June 1. The Heart Rhythm Society's Health Policy staff will continue to monitor the legislation and will provide a detailed summary to keep members informed. If you have any questions, please e-mail Isabelle Le Blanc, Coordinator, Legislative Affairs & Health Policy.
