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The 2010 Medicare Cut is Now a 2.2% "Raise" Until December
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Medpagetoday.com REPORTS HERE that "The House of Representatives voted 417 to 1 to pass a bill to delay a 21% cut in Medicare pay for physicians through Nov. 30 and to give doctors a 2.2% raise retroactive to June 1. The bill is a carbon copy of the bill the Senate passed last week, so now the legislation goes to the president to be signed."
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This just reported by Trailblazers:  "President Signs the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 – 2.2 Percent MPFS Update for June 1 – November 30, 2010"

"On June 25, 2010, 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. CMS has directed Medicare claims administration contractors to discontinue processing claims at the negative update rates and to temporarily hold all claims for services rendered on or after June 1, 2010, until the new 2.2 percent update rates are tested and loaded into the Medicare contractors’ claims processing systems. Effective testing of the new 2.2 percent update will ensure that claims are correctly paid at the new rates. CMS expects to 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 that 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 upon 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."

Note: Physicians/providers should not resubmit claims already submitted to their Medicare contractor.
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Medicare's sustainable growth rate formula has not been eliminated or replaced, however and "by Dec. 1, the mandated SGR cut is expected to be higher than 21%."

"The 21% cut technically went into effect June 1, after Congress failed to pass a bill to stop the cut. But the Centers for Medicare and Medicaid Services (CMS) held claims for the first three weeks of June, and began paying Medicare claims at the lower rate on June 18.  The bill is retroactive to June 1, so CMS will have to reprocess those claims at the 2.2% updated rate."
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Although the Senate passed the six-month pay-fix bill almost a week ago, earlier this week Speaker of the House Nancy Pelosi (D-Calif.) wouldn't allow the House to vote on the measure, saying she didn't see any reason to support the Medicare bill if it lacked tax extension and job creation measures that were originally part of the Senate's bill."

"Pelosi reversed her stance on Thursday when she told reporters during a press conference that the House would vote on the pay-fix bill Thursday because it was clear that the Senate wouldn't pass the tax-extenders bill."

 
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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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