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Home / News & IndustryManaged Care Insight and Analysis
Updated: May 11, 2010
Congress Delays Pending Cuts, Extensions Are Approved

The threatened 21 percent cut in Medicare physician payment has been postponed until June 1, leaving physicians questioning their ability to serve the needy.

Staged-off by Congress, the cuts were pushed back from the original deadline of March 1 to April 1 and now June 1, unfavorable consequences are expected by physicians while they continue to protest for a suitable solution.

"Even before these cuts went into effect, there was widespread frustration and concern among doctors nationwide. Between increased time dealing with paperwork and fighting government red tape over payment, it was becoming harder and harder for doctors to keep their practices open. With these massive cuts, the increase in costs will make it even harder for doctors to keep their practices open. With these massive cuts, the increase in costs will make it even harder for doctors to do the thing they care about the most: spending time helping their patients," said Dr. Lou Goodman, president of The Physicians Foundation.

According to research by the Foundation, 82 percent of primary care doctors believe their practices will be "unsustainable" if the proposed cuts are applied.

"Congress must now turn toward solving this problem once and for all through repeal of the broken payment formula that will hurt seniors, military families and the physicians who care for them. It is impossible for physicians to continue to care for all seniors when Medicare payments fall so far below the cost of providing care," said Dr. J. James Rohack, president of the American Medical Association (AMA).

"In an informal poll, 68 percent of physicians tell the AMA they will be forced to limit the number of Medicare patients they can care for. Already, about one in four Medicare patients seeking a new primary care physician are experiencing difficulty finding one," Rohack continued.

The habitual complaint about the yearly Medicare physician payment update is the sustainable growth rate (SGR).

One respondent to AMA’s poll, a urologist in Cadillac, Mich., said, "I am not sure which is more disruptive; the constant uncertainty each year regarding the SGR, the actual 21 percent cut, or the payment freezes that are now seemingly routine. One thing is for sure, my office will attempt to minimize our exposure to the now-politicized Medicare program. Starting now, we will limit the number of new Medicare patients to 3 per week per provider (down from about 7) and limit surgeries to emergent cases on our existing Medicare patients."

"... We should not be running Medicare on a month-to-month basis," said Senator Chuck Grassley of Iowa, and ranking member of the Committee on Finance.

"These cuts to physician payment cannot be allowed to occur. And as damaging as these would be to beneficiary access to care anywhere, these cuts are even more disastrous for access to care in ruralstates, like Iowa, where Medicare reimbursement is already at least 30 percent lower than in other areas," he continued as he introduced amendments to the Tax Extenders Act of 2009.

One of the amendments he proposed was to delay the pay reductions by 10 months until Dec. 31.

"I fought for my amendment to make sure the cost of important Medicare provisions wasn’t added to the federal deficit, but the majority leader worked to block it and, unfortunately for tax payers, he succeeded," Grassley concluded.

While the pay cut extension was denied before Congress, several other extensions were approved, they are:

  • extension of therapy caps to Dec. 31;
  • extension of pharmacy accreditation deadline under durable medical equipment to Jan. 1, 2011;
  • extension of the mental health add-on until Dec. 31;
  • extension of ambulance add-ons until Jan. 1, 2011;
  • extension of geographic floor for work to before Jan. 1, 2011;
  • extension of outpatient hold harmless provision until Jan. 1, 2011;
  • extension of Medicare Rural Hospital Flexibility program to include 2010, and supply grants until funds are expended; and
  • extension of section 508 hospital reclassification from Sep. 30, 2009 to Sep. 30.

Addresses: American Medical Association, 515 N. State Street, Chicago, IL 60654; (800) 621-8335, www.ama-assn.org. The Physicians Foundation, 77 Summer Street, 8th Floor, Boston, MA 02110; (617) 399-0417, www.physiciansfoundations.org. Senator Chuck Grassley, 135 Hart Senate Office Building, Washington DC 20510; (202) 224-3744, http://grassley.senate.gov.


  This article was taken from:
Healthcare Reimbursement Monitor

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