2010-06-25

Today, President Obama signed into law the "Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010." This law establishes a 2.2 percent update to the Medicare Physician Fee Schedule (MPFS) payment rates retroactive from June 1 through November 30, 2010. The Centers for Medicare & Medicaid Services (CMS) will discontinue processing claims at the negative update rates and temporarily hold all claims for services rendered June 1, 2010, and later, until the new 2.2 percent update rates are loaded into the Medicare contractors' claims processing systems. CMS anticipates that it will begin processing claims at the new rates no later than July 1, 2010. Claims for services rendered prior to June 1, 2010, will continue to be processed and paid as usual.

Claims containing June 2010 dates of service, which have been paid at the negative update rates, will be reprocessed as soon as possible. Under current law, Medicare payments to physicians and other providers paid under the MPFS are based on the lesser of the submitted charge on the claim or the MPFS amount. Claims containing June dates of service that were submitted with charges greater than or equal to the new 2.2 percent update rates will be automatically reprocessed. Affected physicians/providers who submitted claims containing June dates of service with charges less than the 2.2 percent update amount will need to contact their local Medicare contractor to request an adjustment. Submitted charges on claims cannot be altered without a request from the physician/provider. Physicians/providers should not resubmit claims already submitted to their Medicare contractor.

By turning again to a short-term extension, lawmakers are setting up a return to the physician payment issue after the November elections. ASH will continue to work closely with elected officials and with the physician community on a long-term solution to the sustainable growth rate formula and will report on any developments.

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