Archive for November, 2010|Monthly archive page

SGR Reprieve For Holidays

In Uncategorized on November 24, 2010 at 8:33 pm

Just a quick note to let everyone know that late last Thursday, (11/18) the Senate, by unanimous consent, approved a one-month extension of the current payment levels for Medicare Part B. This would avoid the 23% SGR related cut that is scheduled to go into effect on December 1. This temporary extension would postpone the SGR cut until January 1, 2011 unless Congress enacts another “fix” between December1, 2010 and January 1, 2011.

The House has already adjourned until after the Thanksgiving Holiday. However, late last night, House Majority Leader Steny Hoyer (D-MD) announced that he intended to bring up the 30 day extension when the House reconvenes on November 29th.

Majority Leader Hoyer released the following statement following Senate approval of the 30 day extension:

“It is my intention to schedule this bill for consideration when the House reconvenes on November 29th, so we can send it to the President’s desk prior to the November 30th expiration date of current SGR relief.”

Hoyer went on to say,

“This legislation allows Congress to continue our work on a longer- term solution – one which provides our seniors with the security of continued access to the physician of their choice and our physicians with at least one full year of SGR relief.” 

 We’ll keep you posted as developments unfold. 

(Reprinted with permission, Bill Finerfrock, Capitol Associates)


Administration’s Bipartisan Commission on Fiscal Responsibility & Reform Recommends Restrictions On Provider Payments

In Uncategorized on November 12, 2010 at 4:38 pm

A proposal from the bipartisan National Commission on Fiscal Responsibility and Reform aims to direct the CMS to establish a new payment system for physicians; increase cost-sharing in Medicare; and enact comprehensive medical malpractice liability reform to cap noneconomic and punitive damages.

In what it called the “medium term,” the proposal would offset the so-called doc fix in a variety of ways, such as by paying physicians and other providers less and rewarding quality by hastening payment reforms and increasing drug rebates and by expanding cost-sharing in Medicare to promote consumer health choices and spending. For the long term, the plan seeks to contain growth in total federal health spending to the gross domestic product plus 1% after 2020 by “establishing a process to regularly evaluate cost growth and take additional steps as needed if projected savings do not materialize,” according to the report.

Commission Co-chairmen Erskine Bowles, former chief of staff to President Bill Clinton, and former Sen. Alan Simpson (R-Wyo.), released the 50-page proposal, which also attempts to realize healthcare savings by expanding accountable care organizations and payment bundling; cutting Medicare payments for bad debt; placing dual-eligible individuals in Medicaid managed care; increasing nominal Medicaid co-payments; cutting federal spending on graduate and indirect medical education; and converting the federal share of Medicaid payments for long-term care into a capped allotment.

At least 14 members of the 18-member commission, which was created by President Barack Obama, must approve the recommendations before the package can be sent to Congress for action.

 In a statement, the not-for-profit Committee for a Responsible Federal Budget, which focuses on educating the public about fiscal policy, called the proposal a “truly remarkable plan,” saying it would cut the deficit to 2.2% of GDP by 2015; lower national debt by 60% by 2024; and balance the budget by 2037. “The co-chairs’ proposal underscores the depth and breadth of reforms that must be made to the budget if we are to set the foundation for a stronger economy down the road,” Maya MacGuineas, president of the committee, said in a news release. “Yes, some of these changes will be painful—there’s no denying that,” she added. “But we must be mindful of the consequences if we fail to act.”

The American Public Is Concerned About Looming Medicare Fee Schedule Cuts

In Uncategorized on November 9, 2010 at 7:22 pm

The overwhelming majority, 94%, of American adults age 18 and older feel the looming Medicare physician payment cut poses a seiours problem for seniors who rely on Medicare. This number jumped to 98 % of those age 55 and older.

Not surprisingly, therefore, four out of five adults – 81% – stated that Congress should act immediately to stop the Medicare physician payment cut.  This number increased to 91% and 95% for adults over age 55 and over age 65, respectively.This poll was released Monday by the American Medical Association (AMA) at the organization’s semi-annual meeting of physician leaders.

“Our new poll sends a message to Congress that the American people want them to stop the Medicare cut with 95 percent of seniors saying Congress should act immediately to stop it,” said AMA President Cecil B. Wilson, MD, at a news conference. “On December 1 the cut begins, and if Congress has not acted seniors will suffer. We’re pulling out the stops to get Congress to act.”

Wilson said AMA plans to run a new ad in USA Today and in Washington, D.C., publications next week calling for lawmakers to stop the pay cut.

“Physicians want to care for seniors, but it is nearly impossible for many physicians to keep their practices open to all Medicare patients when they face a 25 percent payment cut,” Wilson said.

“The roller coaster ride caused by Congress’ inability to stop the cut for at least a year is eroding physicians’ confidence and commitment to Medicare-right during Medicare’s open enrollment season for physicians,” he said. “There is a growing concern that Medicare is becoming an unreliable payer.”

Wilson said AMA is calling for Congress to stop the cut for at least 13 months, allowing lawmakers to work out  a permanent solution.

CMS Final Rule Issued 11/3/10 Imposes 24.9% Medicare Physician Fee Schedule Cut

In Uncategorized on November 9, 2010 at 7:19 pm

The Centers for Medicare & Medicaid Services has issued a final rule that calls for a 24.9 percent pay cut for physicians beginning Jan. 1.

“While Congress has provided temporary relief from these reductions every year since 2003, a long-term solution is critical,” said Donald Berwick, CMS administrator.

“Broad physician participation in Medicare is essential to ensuring that beneficiaries continue to have access to care, and physician engagement is critical to our efforts to strengthen the quality of care,” Berwick said. “Medicare needs to be a strong, dependable partner with physicians – and that means the SGR must be fixed. The administration supports permanently reforming the Medicare payment formula.”

According to CMS officials, the final rule with comment period continues recent efforts by the CMS to improve the accuracy of Medicare Physician Fee Schedule payment rates by implementing Affordable Care Act mandates to identify and revise payment for misvalued services.

It also addresses concerns about potential physician self-referral by requiring physicians who provide computed tomography, magnetic resonance imaging or positron emission tomography scans in their own offices to notify patients that they may receive the same services from other suppliers in the area.

The rule will also implement key provisions in the Affordable Care Act to expand preventive services for Medicare beneficiaries.

The final rule will appear in the Nov. 29 Federal Register, and CMS will accept comments on certain aspects until Jan. 2, 2011.