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Doctors May Continue to Treat Medicare Patients, at Least Until End of March


Last Thursday, the House of Representatives voted to approve a bill that will delay a planned 21% cut in Medicare physician reimbursement. The original legislation, called HR 3961, was passed in November and originally set to take effect today. The House Bill, called HR 4691 (The Temporary Extension Act of 2010) proposes to delay the cuts until the end of March.

Because the Senate still needs to vote on the bill, the Medicare cuts will still take effect today, but the Centers for Medicare and Medicaid Services (CMS) issued guidance to its contractors on Friday that hold claims for ten days to two weeks until the matter is resolved. Providers will not likely notice these changes, as reimbursement payments often already have a time lag.

According to one recent poll of neurosurgeons, nearly 40% indicated that they planned to cut back on accepting Medicare patients if the reimbursement rate continues to fall. Even established Medicare patients are at risk, as 27% of these surgeons will make administrative changes to treat fewer patients. Some practices fear closure because of reimbursement rates that will decrease by more than one-fifth.

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The changes also affect those with Tricare military coverage.

MedPAC, Congress’ advisory board on Medicare, states that one in four Medicare patients are already feeling the effects of low reimbursement rates and have difficulty finding a primary care physician that will treat their conditions.

The American Medical Association estimates that the 21% cut now will grow to 40% in reimbursement rate decreases by the year 2016 unless Congress acts now to replace the physician payment formula that the association calls “outdated”.

AMA President J. James Rohack MD says, “Our message to the U.S. Senate is stop playing games with Medicare patients and the physicians who care for them. It is shocking that the Senate would abandon our most vulnerable patients, making them the collateral damage of their procedural games."