Medicare Cuts for Doctors Postponed Until March 2010

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Published 12/21/2009 - 12:34 p.m. CDT

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Medpagetoday.com reports here that on December 19, 2009, "The Senate today voted to postpone major cuts in Medicare payments to physicians that were scheduled to go into effect Jan. 1, 2010, in a early vote. The measure was part of a fiscal 2010 defense appropriations bill, which passed 88-10 after Democrats and their allies broke a Republican filibuster aimed at delaying action on its healthcare reform bill. Already approved by the house, the legislation would postpone the cuts from taking effect until March 1, 2010."

"The House passed a bill last month that would repeal the flawed sustainable growth rate (SGR) formula, which is used to calculate Medicare reimbursements for physicians, and replace it with a new formula. But the Senate failed to move beyond a procedural vote on a similar bill, and it's unlikely the Senate will enact any permanent fix before the New Year, when a 21% cut in physician reimbursement was scheduled to take effect." "The standalone bill passed by the House in November would replace the SGR formula with an annual payment increase equal to 1% more than the growth in the GDP -- 2% more for primary and preventive care physicians."

"The SGR was developed in 1997 in an effort to prevent Medicare payments from growing too quickly. The formula indexes reimbursements to changes in the gross domestic product (GDP). But healthcare spending has been growing much faster than GDP, so applying the SGR formula has resulted in reimbursement cuts year after year. And every year, physician groups have gone to Congress asking for an override. So far, they've been successful, but billions of dollars of debt have accumulated as a result of not implementing the cuts."

A link to information for TCA members may be found here: Information Regarding the Holding of Claims for Services Paid Under the 2010 Medicare Physician Fee Schedule

A link to information straight from TrailBlazer Health may be found here: http://www.trailblazerhealth.com/Tools/Fee%20Schedule/MedicareFeeSchedule.aspx?

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