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Senate Gives Doc Fix Six Month Reprieve, But 21% Cuts Go Into Effect Today

John Commins, for HealthLeaders Media, June 18, 2010

The U.S. Senate reached an 11th hour deal today and unanimously agreed to extend a $6.4 billion temporary "doc fix" deadline for 21% cuts in Medicare by another six months.

However, the cuts still go into effect today because the U.S. House won't act on the measure until at least Monday.

CMS today instructed Medicare contractors to lift a temporary hold on claims and services paid since June 1 and begin to process the claims with the 21% reimbursement cuts.

"The CMS is hopeful that Congressional action will be taken to avert the negative update and will continue to monitor those actions. If Congress changes the negative update currently in effect, CMS is prepared to act expeditiously to make the appropriate changes to Medicare claims processing systems," CMS said in a prepared statement.

The Senate action did little to assuage critics of Congress, particularly the American Medical Association, which has long called for a permanent fix.

"It is astounding that Congress has let seniors down through their inability to deal with this problem on time and in a responsible fashion," said AMA President Cecil B. Wilson, MD. "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."

A Republican filibuster on the vote was cleared after Senate Democrats agreed with a GOP demand that the extension would not add to the federal budget deficit. "The fully-paid-for bill that we passed today would stop doctors from taking a 21% pay cut and ensure Nevada's seniors and veterans won't lose access to medical care they depend on," said Senate Majority Leader Harry Reid, D-NV. "This is good news for millions, but we still have much work ahead of us to make sure that we are helping working Americans during these difficult economic times."

Wilson was less enthusiastic, and accused Congress of "playing Russian roulette with seniors' healthcare."

"Congress has finally taken its game of brinksmanship too far, as the steep 21% cut is now in effect and physicians will be forced to make difficult practice changes to keep their practice doors open," he says. "This is no way to run a major health coverage program - already the instability caused by repeated short-term delays is taking its toll."

Wilson says one in five physicians report that they've already been forced to limit the number of Medicare patients, including nearly one-third of primary care physicians.

"The top two reasons physicians gave for these actions were the ongoing threat of future cuts and the fact that Medicare payment rates were already too low," Wilson says.


John Commins is a senior editor with HealthLeaders Media.

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