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Cut in Medicare Physician Pay Delayed Until April 1


 

On March 2, one day after a 21% reduction in Medicare physician pay went into effect, Congress passed—and President Obama signed—a measure that would delay implementation of the cut until April 1.

The Temporary Extension Act of 2010 (H.R. 4691) extends the zero percent update in the Medicare sustainable growth rate (SGR) formula through March 31. That zero percent increase went into effect Jan. 1, but expired March 1.

Just before the expiration date, the Centers for Medicare and Medicaid Services (CMS) instructed its contractors to hold all of the claims submitted from March 1 through at least March 12. This was because the agency anticipated a temporary extension to be approved by Congress.

After the extension, the CMS said that all claims were being immediately released for payment.

With the debate on health care reform ongoing, the fate of the SGR has been largely an afterthought on Capitol Hill.

The House passed a permanent repeal of the formula as part of its health reform package. The Senate, however, included only a temporary fix in the proposal it passed in late December. As part of February legislation to raise the national debt limit, the Senate made a fiscal promise to delay the SGR-mandated cuts for 7 months.

But the solution that passed political muster was the 1-month extension that was included in a package that also extended unemployment benefits.

In a statement issued shortly after the temporary fix was approved, Dr. J. James Rohack, president of the American Medical Association (AMA), directed his ire at the Senate.

“The Senate should use this time to permanently repeal the flawed Medicare physician payment formula that puts access to care for seniors and military families at risk,” Dr. Rohack said in the statement. “Physicians are outraged by the Senate's failure to act before the March 1 deadline, as their patients and practices are hurt by the continued instability in the Medicare system.”

The AMA, along with other physician organizations, is urging Congress to find a permanent fix to the SGR.

In a speech at the AMA's annual advocacy conference in Washington on March 3, Rep. Michael Burgess (R-Tex.), who is also a physician, said it appeared Congress did not grasp the “pernicious” effect temporary rate extensions had on physician practices.

He has introduced his own solution to permanently replace the SGR.

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