SGR Update

The Senate has passed a 6 month SGR "fix". The legislation was broken out from the larger tax extenders/unemployment legislation to which it had been attached. The legislation must now be passed by the House which has already adjourned for the day. The House will take up the legislation Monday or Tuesday of next week.

Earlier today CMS instructed Carriers to begin processing June claims at the 21% reduced rate. Previously held claims are now being processed on a flow basis, first-in/first-out. If history is any indication Carriers will reprocess claims automatically once legislation is passed.

Here is a summary of the proposal passed by the Senate:

• Medicare Physician Payment: Provides a 2.2% increase in reimbursement levels for June-November of 2010. Spends $6.4 billion over five and ten years.
• Hospital Payments: Prohibits Medicare from reopening or adjusting claims made by hospitals during the three days preceding a patient's inpatient admission.
• Pension Relief: Offers the same relief from pension funding obligations for companies that will result in fewer tax-preferred contributions to pension plans and therefore more taxable income for the firms, and generates $675 million in outlay savings due to lower than expected payments by the Pension Benefit Guarantee Corporation (PBGC). Saves $2.8 billion over ten years.
• IRS Data Match: Includes provisions allowing the IRS and CMS to coordinate data matching efforts with regard to delinquent tax debts owed by Medicare providers, and to take such information into account when releasing reimbursement payments and accepting new providers. Saves $175 million over five years and $425 million over ten.

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