Updated 06/25/2010

President Signs the Six-Month Medicare 'Doc Fix' into Law

Last night, the U.S. House of Representatives voted 417-1 to approve a temporary fix that will avert a 21.3 percent cut in payments to physicians who treat Medicare patients. This finalized a bill that had been passed by the Senate earlier this month and the President signed it into law today, Friday, June 25, 2010.

This temporary relief will provide physicians with a 2.2 percent increase in payments through November 30, 2010 and it will be applied retroactively to claims for services provided on or after June 1. Physicians will be facing cuts in December.

Today, the Centers for Medicare & Medicaid Services (CMS) directed Medicare claims administration contractors to discontinue processing claims at the negative update rates and to temporarily hold all claims for services rendered June 1, 2010 and later, until the new 2.2 percent update rates are tested and loaded into the Medicare contractors' claims processing systems. Effective testing of the new 2.2 percent update will ensure that claims are correctly paid at the new rates. CMS expects to begin processing claims at the new rates no later than July 1, 2010. Claims for services rendered prior to June 1, 2010 will continue to be processed and paid as usual.

Claims containing June 2010 dates of service that have been paid at the negative update rates will be reprocessed as soon as possible. Under current law, Medicare payments to physicians and other providers paid under the MPFS are based upon the lesser of the submitted charge on the claim or the MPFS amount.

Claims containing June dates of service that were submitted with charges greater than or equal to the new 2.2 percent update rates will be automatically reprocessed. Affected physicians and providers who submitted claims containing June dates of service with charges less than the 2.2 percent update amount will need to contact their local Medicare contractor to request an adjustment. Submitted charges on claims cannot be altered without a request from the physician or provider. Physicians and providers should not resubmit claims already submitted to their Medicare contractor.

Senate Passes Six-Month Temporary Fix; House to Vote Week of June 21

During the week of June 14-18, the U.S. Senate debated temporary 'fixes' to avert the 21.3 percent cut in physician Medicare payments. This cut was scheduled to go into effect on June 1, but the Centers for Medicare and Medicaid Services (CMS) called on its contractors to temporarily hold processing. CMS contractors are required by law to begin processing the claims on Friday, June 18.

After defeating several amendments earlier this week, the Senate Finance Committee Leadership finally found a compromise late on Thursday, June 17, agreeing to a six month temporary fix, which would offer physicians a 2.2 percent increase in payments through November 30. Physicians then will be subject to cuts in December.

The Senate approved this temporary fix by unanimous consent on the afternoon of Friday, June 18. The amendment must be sent to the U.S. House of Representatives for approval, as it differs from the previously House-passed 19 month fix. The House, having already adjourned before this passage, will vote on this amendment early in the week of June 21.

Summary of the proposals that were introduced during this debate:

• Senator Baucus introduced an amendment which included a 19 month temporary fix identical to the one passed by the House of Representatives on May 27. 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.
• Senator John Thune (R. SD) introduced an amendment which would have provided a 2 percent increase until 2011. Physicians then would have been subject to cuts in 2012. According to the released background documents, this amendment would have been fully offset. This amendment was defeated by a 41-57 vote.
• Sen. Jon Kyl (R-AZ) introduced an amendment which would have provided physicians with a 1 percent update in 2010 and a 1 percent update in 2011. According to the released background documents, this amendment would have been fully paid for. This offset of this amendment would have helped reduce the 'cliff effect' and invest in permanent reform by ensuring a cut no greater than -9 percent in 2012. (Status: no vote)