Fresh of the presses: Congress fails to prevent April 1 cut in Medicare

kstreet

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March 26, 2010

Congress fails to prevent April 1 cut in Medicare physician payments

Last night, the U.S. Senate held floor debate on a bill, H.R. 4851, that would extend a number of expiring programs through April. That bill, which had already passed the U.S. House of Representatives, includes a 30-day extension of current Medicare physician payment rates, postponing once again the 21.3 percent cut scheduled to take effect this year. It also addresses a number of other programs such as extensions of COBRA benefits and unemployment insurance benefits for Americans who have lost their jobs.

In a replay of the standoff that occurred a month ago, Sen. Tom Coburn, R-Okla., objected to the bill’s consideration on the basis that it should not be considered emergency spending that would be exempt from budgetary offsets. As a result, Congress will adjourn for its two-week spring recess without taking action to stop these programs from expiring. We are told that the Senate plans to hold a cloture vote after the recess which, if supported by 60 senators, will allow a vote to occur on the legislation. That vote is scheduled for the evening of April 12.

Congress failed to act yet again, and as a result, the 21.3 percent Medicare physician payment cut will take effect on April 1. The AMA has contacted the Centers for Medicare and Medicaid Services (CMS), and they will be making an announcement shortly about their plans for handling the situation. Judging from past experience, CMS will not be forced to process claims at the reduced payment rates for 10 business days.

This repeated game of brinksmanship is wreaking havoc with physician practices and is causing both physicians and patients to lose confidence in the Medicare program. It illustrates in stark terms why medicine can no longer support short-term “fixes” to a formula that we knew would not work at the time Congress created it.

Physicians are urged to track down their representatives and senators during their spring break and hold them accountable for their inability to do what they know is right for patients and their physicians. Forty-five million Americans count on Medicare, and physicians simply cannot run viable practices in an environment with such extreme financial uncertainty. Medicine knew when Congress created the sustainable growth rate (SGR) formula that it would not work, and this point has been proven every year for nearly a decade. Congress must stop playing games with physicians and patients and do what they know must be done: Repeal the SGR formula once and for all.
So this is what the AMA gets for tepid support of the bill. I hope you guys know what you're getting into. :luck:
 

cliffhuxtableDO

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what's the source? this is not good.
 

Bacchus

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The AOA just e-mailed me to. This was not in the reform bill and there is separate legislation for it.
 

Bernoull

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So this is what the AMA gets for tepid support of the bill. I hope you guys know what you're getting into. :luck:
So republicans continue to be republiicans, i mean obstructionists, we had Bunning single-handedly denying people unemployment benefits and now Coburn's doing it..
 

Impromptu

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A year to year fix has never been the right thing to do. I would rather have a real fix to the problem, even if it meant a short time with the 21% cuts. That will raise real ire and put the fear of elections into the politicians, which is the only thing they understand.
 

cliffhuxtableDO

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This is actually just the sort of kick in the arse that Congress needs to finally fix the SGR formula. When the wailing and gnashing of teeth from providers and (more importantly) seniors raises the electoral stakes, we stand a better chance of definitive action.
A year to year fix has never been the right thing to do. I would rather have a real fix to the problem, even if it meant a short time with the 21% cuts. That will raise real ire and put the fear of elections into the politicians, which is the only thing they understand.
So this is potentially a good thing and shouldn't cause concern for a pre-med who wants to avoid being in debt forever?
 

JJMrK

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The AOA just e-mailed me to. This was not in the reform bill and there is separate legislation for it.
The cuts were taken into account by the CBO when they looked at the fiscal impact of the reform bill, though. These cuts are a part of the reason the bill is budget neutral; as soon as the cuts get postponed again the healthcare reform bill adds the the deficit.
 
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Not a big deal - they'll pass the extension retroactively once they get back. Word on the street is they are waiting until October-ish to permanently replace the SGR once everything cools down with health reform. I believe the AMA has been assured that the issue will be addressed before the midterm elections, otherwise, the AMA wouldn't have supported the bill.
 

traderjoe

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A year to year fix has never been the right thing to do. I would rather have a real fix to the problem, even if it meant a short time with the 21% cuts. That will raise real ire and put the fear of elections into the politicians, which is the only thing they understand.
agreed. I've got a brilliant idea...let's offer no progressive changes to health care when the climate is ripe and then let's drive all primary care doctors who take medicare into bankruptcy....

maybe they will run for office and get some of these a-holes out of office.
 

traderjoe

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Not a big deal - they'll pass the extension retroactively once they get back. Word on the street is they are waiting until October-ish to permanently replace the SGR once everything cools down with health reform. I believe the AMA has been assured that the issue will be addressed before the midterm elections, otherwise, the AMA wouldn't have supported the bill.
I hope you are right.

more importantly you reminded me that I have a tasty dark roast I brewed before I got to work waiting for me in the microwave. it's good enough stuff to reheat.
 

Parts Unknown

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So this is potentially a good thing and shouldn't cause concern for a pre-med who wants to avoid being in debt forever?
Unless you are prone to frank paranoia, this shouldn't be concerning.

Look at it this way: in 20 years there are going to be trillions of dollars spent treating millions of ancient boomers. There will be some for you.
 

cliffhuxtableDO

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Unless you are prone to frank paranoia, this shouldn't be concerning.

Look at it this way: in 20 years there are going to be trillions of dollars spent treating millions of ancient boomers. There will be some for you.
Haha thanks :thumbup:
 

chocchipcookie

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probably a stupid question, but if we know that they're looking to cut reimbursements by 20%, couldn't we just over charge by that much and not lose anything?

ps it's late, so if that came off really stupid...sorry and ignore me lol
 

Parts Unknown

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probably a stupid question, but if we know that they're looking to cut reimbursements by 20%, couldn't we just over charge by that much and not lose anything?
Not so easy. If you agree to accept Medicare you agree to accept their reimbursement and not charge more. It's intended to keep providers from bilking Medicare recipients.
 

Narmerguy

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probably a stupid question, but if we know that they're looking to cut reimbursements by 20%, couldn't we just over charge by that much and not lose anything?

ps it's late, so if that came off really stupid...sorry and ignore me lol
Not so easy. If you agree to accept Medicare you agree to accept their reimbursement and not charge more. It's intended to keep providers from bilking Medicare recipients.
Similarly, a lot of private insurers use Medicare prices to determine how much they will charge so this will impact non-medicare patients as well.
 

chocchipcookie

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thanks for the responses.

so now, since we're all young and don't have our own practices yet, how do we decide how much we can/will charge? because then couldn't we just play with some numbers and figure out what would be ideal and go with that? how does this work (setting prices and getting reimbursed, etc)?
 

DrBowtie

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Not a big deal - they'll pass the extension retroactively once they get back. Word on the street is they are waiting until October-ish to permanently replace the SGR once everything cools down with health reform. I believe the AMA has been assured that the issue will be addressed before the midterm elections, otherwise, the AMA wouldn't have supported the bill.
You have a lot more faith in the AMA than I do.