The impending 21% cut to the Medicare Physician Fee Schedule received a six-month reprieve—one week after the cut had already taken effect.
In late June, President Obama signed a law that establishes a 2.2% update to the Medicare Physician Fee Schedule payment rates retroactive from June 1 through November 30, 2010. “We need to permanently reform the Medicare formula in a way that attacks our fiscal problems without punishing our hard-working doctors or endangering the benefits on which so many of our seniors rely,” Obama said in a statement after the vote. “I look forward to working with Congress to achieve that goal, and I’m gratified that in the meantime they’ve taken the provisional step of blocking this pay cut.”
This law reversed the 21% cut that Medicare contractors began applying to claims a week earlier.
The president is hardly the only one with the goal to achieve a permanent solution to the Medicare Physician Fee Schedule.
“Since Congress has again chosen a short-term ‘fix,’ the AOA will continue urging Senators and Congressmen to approve the type of Medicare physician payment reform that will make massive fee cuts—like the 21% cut that took effect on June 1st and has finally been corrected—a thing of the past,” says Joe Ellis, O.D., newly inducted president of the American Optometric Association. “The Medicare payment crisis is a real and continuing threat to optometrists and our patients. All of us are concerned about the instability and uncertainty that the entire program faces when this fix expires at the end of November and faces further cuts in 2011.”
For claims made during this period, the Centers for Medicare & Medicaid Services says:
• Claims for services rendered prior to June 1 will continue to be processed and paid as usual.
• Claims containing June dates of service that were submitted with charges greater than or equal to the new 2.2% update rates will be automatically reprocessed.
• Claims containing June 2010 dates of service that have been paid at the decreased rate (less 21%) will be reprocessed as soon as possible. Claims should be paid within 14 days of submission and will reflect Congress’s belated directive to correct the 21% cut and provide for a 2.2% increase retroactive to June 1st (and extending through November 30).
• Claims with June dates of service with charges less than the 2.2% update amount require you to contact your local Medicare contractor to request an adjustment.
• Don’t resubmit claims already submitted to your Medicare contractor.