Senate reaches Medicare physician payment deal, House scheduled to vote next week

Posted by KUNAL JAIN on Jun 22 2010

Fotolia_49213323_Subscription_Monthly_MThe Senate just passed via a unanimous consent agreement a provision blocking the 21.3 percent cut to Medicare physician payments until Nov 30. Since this provision is different than the House-passed version, the House of Representatives must vote on the matter again and is expected to do so next week. If this bill becomes law, medical practices will receive a 2.2 percent increase to Medicare physician payment for claims with dates of service of from June 1 through Nov. 30.

Today the Centers for Medicare & Medicaid Services (CMS) released the following statement:

The Continuing Extension Act of 2010, enacted on April 15, 2010, extended the zero percent update to the 2010 Medicare Physician Fee Schedule (MPFS) through May 31, 2010.

On May 27, 2010, the Centers for Medicare & Medicaid Services (CMS) initially instructed contractors to hold claims for services paid under the MPFS for the first 10 business days of June. On June 14, CMS extended this hold for an additional three business days (i.e., through June 17, 2010). This hold only affected MPFS claims with dates of service of June 1, 2010 and later.

The CMS today directed contractors to lift the hold and begin processing June 1 and later MPFS claims under the law’s negative update requirement. Held claims will be released and processed on a flow basis, first-in/first-out.

Congress continues to debate the elimination of the negative update that took effect June 1, 2010. The CMS is hopeful that Congressional action will be taken to avert the negative update. We continue to monitor Congressional actions, and if Congress changes the negative update that is currently in effect, we are prepared to act expeditiously to make the appropriate changes to Medicare claims processing systems.

MGMA encourages members to continue urging Congress to comprehensively address Medicare physician payment cuts through the immediate repeal of the Medicare sustainable growth rate formula.


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Topics: Medicare, CMS

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