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6 MONTH REPRIEVE FROM MEDICARE CUTS
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"The U.S. Senate passed an amended version of H.R. 3962, now called the “Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010,” by unanimous consent this afternoon. This legislation provides a 2.2 percent Medicare physician payment update for six months, from June 1 through Nov. 30, in lieu of the 21 percent cut scheduled for 2010."

The bill -- which also gives doctors a 2.2% increase in reimbursements -- was approved by voice vote Friday afternoon.  Recognizing that the tax extenders bill was stalled, the "doc fix" portion was removed from the larger bill and placed in its own measure.

The bill now goes to the House, but members have already left for the weekend, so a vote will have to wait until Monday at the earliest. That means CMS will process claims at the lower rate until then, unless the agency announces otherwise

"Unfortunately, the U.S. House of Representatives is not scheduled to hold any floor votes until the evening of June 22. As a result, the Centers for Medicare and Medicaid Services (CMS) is instructing its carriers to lift the hold on processing claims for services provided on or after June 1, and to begin processing them under the law’s negative update requirement. In other words, claims will begin to be paid today at the 21 percent lower rate on a first-in/first-out flow basis."

"Once H.R. 3962 is passed by the House and signed by President Obama, CMS will retroactively adjust any June claims that have been paid."

In a follow up to this story, Medpagetoday.com REPORTS HERE "It takes 14 days to pay electronic claims, so in a few weeks, doctors will see reimbursements that are 21% lower than they would normally receive, unless Congress takes action or CMS grants yet another extension. If Congress does pass a retroactive SGR fix, CMS will need to reprocess the claims it paid at the 21% lower rate."

"Although members of Congress universally acknowledge that the SGR is a flawed formula and should be retooled, political will to totally overhaul the formula has been lacking. And this year, short-term fixes have also been subject to major push-back."

"Continued short-term actions are creating severe instability that harms seniors as physicians make decisions to protect their practices from Medicare's volatility," said AMA president Cecil Wilson, MD.  One of those decisions that physicians must make is whether to continue to accept Medicare patients. Doctors have long threatened to stop seeing them if severe reductions in reimbursement go into effect.  Large group practices may be able to weather the cut in pay, but small group practices and solo physicians -- particularly those in primary care and in rural areas -- will have a tough time..."

Source:  American Medical Association; Medpagetoday.com
 
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U.S. government overpaid private insurance companies administering Medicare Advantage plans by as much as $3.1 billion in 2010, according to a new report from the Government Accountability Office (GAO).

About a quarter of all Medicare beneficiaries are enrolled in Medicare Advantage plans, and the Centers for Medicare and Medicaid Services (CMS) paid about $114 billion to the plans in 2010.


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