Congress Misses Deadline Again To Postpone Doc Fix

Janice Simmons, May 28, 2010

The House, which had appeared close to voting Thursday on the "American Jobs and Closing Tax Loopholes Act of 2010" (HR 4213) that contains a provision to delay a 21% cut in physician Medicare reimbursements after a June 1 deadline, faltered over concerns about the bill's costs voiced by Republicans and some Democrats.

The House will continue deliberations today. However, the delay means that the bill would not make it in time to be voted on by the Senate. Late Thursday, Democratic leaders in the Senate acknowledged they would not be able to approve a bill before adjourning for the Memorial Day weekend.

This means that, like earlier this year, the deadline to postpone the Medicare Sustainable Growth Rate (SGR) formula from going into effect will be missed—meaning providers could theoretically face cuts.

However, the Centers for Medicare and Medicaid Services (CMS), as it did earlier this year, has instructed its contractors to hold claims containing services paid under the Medicare physician fee schedule for the first 10 business days of June—while Congress deliberates on postponing the SGR.

CMS said the 10 day hold—which will apply to claims with dates of service June 1 and later—should have little overall impact on provider cash flow since electronic claims are not paid until at least 14 days following claims receipt.

The missed deadline, however, has not sat well with the American Medical Association. "The Senate has turned its back on seniors, and America’s physicians are outraged that Congress has deserted patients by failing to address this year's Medicare cut before the June 1 deadline," said AMA President J. James Rohack, MD, in a statement.

"Senators are more interested in heading home for the holiday than in preventing a Medicare meltdown for seniors. The 21% Medicare physician payment cut has been looming all year, and yet all Congress has managed to do is repeated short term delays," Rohack said. "This is complete mismanagement of a healthcare program that America’s seniors and the disabled rely on."

"Enough is enough. Nine times in eight years Congress has delayed the cut and not fixed the problem. Congress needs to buckle down, stop growing the problem, and fix it once and for all," he added.

Under the latest proposed "doc fix" being considered by the House, physicians would see an increase in payment rates of 2.2% for the remainder of 2010 and a 1% increase in 2011. Rates would return to present law after 2011.

One group in the House that opposes the bill in the current form is the conservative Democratic Blue Dog Coalition, which said it wanted unemployment insurance and health subsidies for laid off workers cut even more before they would vote for the package.

Janice Simmons Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at
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