Left stranded by Congress taking a two-week holiday, the Centers for Medicare & Medicaid Services for the second time this month has told contractors to delay reimbursements to physicians and other healthcare providers for 10 business days to temporarily avoid the 21.2% Medicare pay cuts that go into effect on April 1.
"CMS believes Congress is working to avert the negative update that will take effect April 1. Consequently, CMS has instructed its contractors to hold claims containing services paid under the Medicare Physician Fee Schedule Update (including anesthesia services) for the first 10 business days of April," CMS said in a media release. "This hold will only affect claims with dates of service April 1, 2010, and forward. In addition, the hold should have minimum impact on provider cash flow because, under the current law, clean electronic claims are not paid any sooner than 14 calendar days (29 for paper claims) after the date of receipt. "
On March 2, the Temporary Extension Act of 2010 extended the deadline to the 2010 MPFS through March 31.
As Congress left the Capitol for spring break last weekend, the American Medical Association blasted lawmakers for the "unconscionable" action of not acting on the "doc fix."
Earlier this month, the Senate voted to delay the physician pay cut until Oct. 1. But the House did not take up the action, and as a result, the April 1 deadline stands. Some congressional officials have said it is likely that Congress may decide on the bill retroactively. The House doesn't vote again on legislation until April 13, according to the House calendar.
AMA President J. James Rohack, MD, said last week, "It is unconscionable for elected officials to play politics with seniors and military families who rely on them to preserve their ability to see the physician of their choice."
"Members of Congress eager to spend a two-week holiday with their families have left America's military families and seniors to fend for themselves through their inaction on a known threat to the Medicare and TRICARE programs," Rohack stated.
The physician pay cut issue has been dependent continually on congressional action, much to the consternation of physicians. On Dec. 19, Congress voted to delay the scheduled payment cut until March 1. Both houses then extended it a month.
Specifically, the Medicare payments were scheduled to be cut across the board in accordance with the sustainable growth rate (SGR) formula.
The proposed delay ostensibly is to give Congress time to adjust the SGR formula. SGR links Part B Medicare reimbursement to the gross domestic product. The formula has led to proposed large cuts annually, which physicians have successfully worked to delay.