Medicare Physician Payments

Update from Julie Hart with Congressman Gonzalez’ Office

As you know, a 10.6% reduction in Medicare physician payments is scheduled for July 1, 2008.  Last week, the House overwhelmingly passed a bill that would have provided for an 18 month fix to this impending cut. It would have also provided a 1.1% increase for 2009.  Unfortunately, the bill failed to pass the Senate by one vote needed to invoke cloture (the President has issued a veto threat on the legislation).  So, the Senate is still wrestling with negotiations on legislation that would address the problem.  This week, both chambers are in recess and won’t return until July 7. So, work on a fix is delayed.

This morning, I received notice from CMS relaying its “plans to instruct its contractors to not process any physician and non-physician practitioner claims for the first 10 business days of July.  Under current law, electronic claims are not to be paid any sooner than 14 days (29 days for paper claims) and not later than the 30th day they are submitted (otherwise, CMS must pay interest on those claims).  By holding claims for health care services that are delivered on or after July 1, CMS will not be making any payments on the 10.6 percent reduction until July 15, at the earliest.  Meanwhile, all claims for services delivered on or before June 30 will be processed and paid in regular order.  In addition to the temporary hold on July claims, CMS is considering additional actions the agency can take to address other expiring Medicare and Medicaid provisions.”  I should receive a complete list of those actions soon.

CMS is working to make what has become a retroactive fix to this issue less burdensome. It is expected that a bill addressing this problem will be considered next week (be it the House bill or another version). I’ll keep you posted on further developments.

One more thing….I hope you have a wonderful and safe 4th of July Holiday!!!