Congress fails to prevent April 1 cut in Medicare physician payments

Fri Apr 2 16:24:01 PDT 2010

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March 26, 2010

Congress fails to prevent April 1 cut in Medicare physician payments

The American Medical Association<http://www.ama-assn.org/>

Last night, the U.S. Senate held floor debate on a bill, H.R. 4851, that would extend a number of expiring programs through April. That bill, which had already passed the U.S. House of Representatives, includes a 30-day extension of current Medicare physician payment rates, postponing once again the 21.3 percent cut scheduled to take effect this year. It also addresses a number of other programs such as extensions of COBRA benefits and unemployment insurance benefits for Americans who have lost their jobs.
In a replay of the standoff that occurred a month ago, Sen. Tom Coburn, R-Okla., objected to the bill's consideration on the basis that it should not be considered emergency spending that would be exempt from budgetary offsets. As a result, Congress will adjourn for its two-week spring recess without taking action to stop these programs from expiring. We are told that the Senate plans to hold a cloture vote after the recess which, if supported by 60 senators, will allow a vote to occur on the legislation. That vote is scheduled for the evening of April 12.

Congress failed to act yet again, and as a result, the 21.3 percent Medicare physician payment cut will take effect on April 1. The AMA has contacted the Centers for Medicare and Medicaid Services (CMS), and they will be making an announcement shortly about their plans for handling the situation. Judging from past experience, CMS will not be forced to process claims at the reduced payment rates for 10 business days.

This repeated game of brinksmanship is wreaking havoc with physician practices and is causing both physicians and patients to lose confidence in the Medicare program. It illustrates in stark terms why medicine can no longer support short-term "fixes" to a formula that we knew would not work at the time Congress created it.

Physicians are urged to track down their representatives and senators during their spring break and hold them accountable for their inability to do what they know is right for patients and their physicians. Forty-five million Americans count on Medicare, and physicians simply cannot run viable practices in an environment with such extreme financial uncertainty. Medicine knew when Congress created the sustainable growth rate (SGR) formula that it would not work, and this point has been proven every year for nearly a decade. Congress must stop playing games with physicians and patients and do what they know must be done: Repeal the SGR formula once and for all.

Abid Mogannam &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service
University of California, Irvine
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