Physician Fee Cut on Hold & 2.2% Increase for now

Docs Get Six-Month Reprieve; Industry Looking for Longer Fix
WASHINGTON—President Obama signed legislation Friday canceling a scheduled 21.2 percent pay cut for Medicare physicians and instead giving them a 2.2 percent increase. While it offers the docs some current relief, the new measure is effective only through the end of November.

That means months, a decade even, of congressional wrangling over the issue could start up again before the year’s end, offering HME advocates another shot at a possible legislative vehicle that could carry language to stop competitive bidding.

The American Medical Association and other physician groups have been urging Congress to revise Medicare’s current “sustainable growth rate,” or SGR, payment formula—which has resulted in annual pay decreases for physicians over the past decade—in favor of a permanent fix. But the cost of such a change has quashed any long-term action.

“Delaying the problem is not a solution,” the AMA said in a statement issued last week. “It doesn’t solve the Medicare mess Congress has created with a long series of short-term Medicare patches over the last decade—including four to avert the 2010 cut alone.”

In December, the physician pay cut “will be a whopping 23 percent, increasing to nearly 30 percent in January,” the statement read.

“The baby boomers begin entering Medicare in six months, and if the physician payment problem isn’t fixed, these new Medicare patients won’t be able to find a doctor to treat them,” the AMA said.

In a Friday afternoon legislative update, Waterloo, Iowa-based VGM Group said because the cuts to physician reimbursement have only been postponed through November, “the temporary ‘doc fix’ will need to be addressed once again towards the end of the year. This will offer another vehicle to eliminate competitive bidding.”

In the meantime, the group urged continued support for H.R. 3790 to repeal the bidding program.

LATE-BREAKING: CMS’ proposed physician fee schedule for 2011, released late Friday, calls for a 6.1 percent cut for Medicare physician services that would take effect Jan. 1, 2011.

As outlined under health reform, the proposed regulation would also expand Round 2 of the DMEPOS competitive bidding program from 70 MSAs to 91, for a total of 100 in the national bidding program.

Taken from weekly email blast received today.

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Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.