2010-03-26

The U.S. Senate has been unable to prevent the scheduled 21 percent Medicare physician payment cut from going into effect on April 1. On March 25, the Senate debated HR 4851, a bill that would extend a number of expiring programs through April. That bill, which had already passed the House of Representatives, includes a 30-day extension of current Medicare physician payment rates, postponing once again the cut scheduled to take effect in 2010. It also addressed a number of other important programs, such as the extension of COBRA benefits and unemployment insurance benefits for Americans who have lost their jobs.

Despite hours of negotiations between Democrats and Republicans, Senator Tom Coburn (R-OK) objected to the bill’s consideration on the basis that it should not be considered emergency spending that would be exempt from budgetary offsets. At one point Democratic Majority Leader Harry Reid thought he would have agreement to pass at least a one-week extension that would have covered the program until after the Senate’s recess and potentially given the House and Senate time to finish work on a one-year extension bill that had previously stalled. However, Democrats ultimately objected to that deal, forcing Senator Reid to end the talks and the Senate to adjourn for its two-week spring recess without taking action to stop these programs from expiring. ASH has been 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 could occur as early as April 12.

In the meantime, the Centers for Medicare & Medicaid Services (CMS) has announced that it believes Congress can resolve this problem and that it wants to avoid disruption in the delivery of health-care services and payment of claims for physicians, non-physician practitioners, and other providers of services paid under the Medicare Physician Fee Schedule. Consequently, CMS has instructed its contractors to hold claims containing services paid under the Medicare Physician Fee Schedule for the first 10 business days of April. 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.

It is critical that members of Congress hear from their physician constituents during the spring recess. Please join ASH’s advocacy campaign today to urge the Senate to pass legislation to prevent physician payment cuts and protect physician access to Medicare and TriCare beneficiaries.

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