Congress Fails, 21% Cut Will Occur

The Senate adjourned for the Easter Recess leaving 21% Medicare fee cut on the table.

Due to Easter Recess the Senate will not return to take up the 21% Medicare Physician Fee Schedule (MPFS) cut until April 12, 2010. This means that the 21% reduction will take effect April 1, 2010.

When the Senate returns it intends to take up bill H.R. 4851 which would fix the Sustainable Growth Rate (SGR). However, it is unclear whether or not it will have the votes necessary to pass.

Unless things change during the recess, there may be additional days of debate before the bill is passed. Ultimately, Congress is expected to pass either a freeze or fix to the SGR, which would be retroactive to April 1, 2010. Providers should be prepared for the possibility of claims being paid at the reduced rate.

Also, today CMS instructed contractors to hold claims containing services paid under the MPFS for the first 10 business days of April. This hold will only affect claims with dates of service April 1, 2010 and forward. This action should help minimize the impact on cash flow for offices.

Med USA will continue to monitor this situation and keep you informed of the latest developments. If you have any questions please feel free to contact Liz Gardner at 801.352.9500 ext 1308 or email lgardner@medusabil.com