ASAP - 5-28-10 - Senate adjourns without SGR fix; CMS to hold claims

[Guest guest]

Here is the latest news from my state medical society on Medicare and the SGR fix.

 

Sigh.

 

Locke, MD

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Date: Fri, May 28, 2010 at 3:48 PMSubject: ASAP - 5-28-10 - Senate adjourns without SGR fix; CMS to hold claimsTo: kelly@...

ASAP - An Electronic Publication of the Colorado Medical Society

May 28, 2010Review the CMS member benefits page. These vendors help support ASAP.

IN THIS ISSUE

1. Update from CMS President-elect Mike Pramenko, MD

2. No SGR fix; CMS once again to hold claims

1. SGR Update from CMS President-elect Mike Pramenko, MD

I've just returned from our nation's capitol, where West, MD; Edie Sonn, CMS Senior Director of Public Affairs; and I lobbied Colorado's congressional delegation about the pending bill to replace the SGR.

 The outlook isn't good. The bill (H.R. 4213 discussed in more detail in the story below) passed the House today, but the Senate adjourned until June 7 without taking action. We met with staffers for every member of our delegation but Rep. DeGette and all told us their members had concerns about the bill. They all said that their members strongly support replacing the SGR but the unpaid cost of the bill (which, as you know, also extends COBRA payments, unemployment insurance, enhanced Medicaid payments and much more) was keeping them from supporting it. Unfortunately, it does not appear to be possible to carve the SGR piece out of the bill to be voted on separately.

 We shared with them the results of the CMS flash poll about physician participation in Medicare (click here for a summary of the poll results so far), pointing out that access problems for Medicare and TriCare patients will worsen even with a 1.5% payment update.  We warned them that the volume of calls they are already receiving from Medicare patients who cannot find a doctor will increase.  We explained what it's like for physicians to be taken to the brink of a 21.5% cut, then to be given a 30-day " reprieve " that includes going without pay for 2 weeks while Centers for Medicare & Medicaid Services waits to see what Congress is going to do.  We told them: " This bill is far from perfect - but it will give you 19 months to come up with something better and minimize physicians' uncertainty during that time.  There's nothing else on the table right now, so vote for this and use this time to develop a real fix. "

 We share your dismay over this turn of events.  It is unconscionable that our leaders in Washington cannot - will not - fix this problem.  I urge you to call our senators and your representative and tell them what Congress' mismanagement of the Medicare program is doing to America's doctors and their patients. Call the AMA grassroots hotline, at 1-, or send an email by clicking here.

2. Senate adjourns until June 7 without action on SGR

Ten-day hold on claims will begin June 1This afternoon, the House passed an amended version of H.R. 4213, the " American Jobs and Closing Tax Loopholes Act of 2010, " which includes provisions to suspend Medicare physician payment cuts produced by the sustainable growth rate (SGR) formula for 19 months.  In lieu of the 21 percent cut originally scheduled for 2010, the House-passed proposal would implement a 2.2 percent payment update for the remainder of this year, and a 1 percent payment update for 2011.  In 2012, the SGR formula will resume, with an estimated 33 percent payment cut taking effect that year.

 The SGR provisions were voted on separately from the rest of the legislation, passing on a bipartisan vote of 245 to 171. To see how your Representative voted, click here.

 Because the Senate is adjourning for the week-long Memorial Day Recess, it will not vote on the legislation until after it returns on June 7.  This represents the third time in 2010 that Congress has missed a deadline, causing a Medicare payment cut to take effect.  As was previously the case, the Centers for Medicare & Medicaid Services has instructed its carriers to hold Medicare claims for services provided on or after June 1 for 10 business days, until June 14, which should provide sufficient time for Congress to stop implementation of the cut retroactively. 

 Physicians are encouraged to contact Congress to explain how its mismanagement of the Medicare program is wreaking havoc on their practices.  They should use the AMA grassroots hotline, at 1-, or send an email by clicking here.   

You may also sign an online petition telling Congress to fix the SGR here.

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