A Two Month “Doc Fix” for Reimbursements
It’s become ‘business as usual’ for doctors who see patients with Medicare.
Every so often, they are threatened with a cut to their Medicare reimbursements mandated by a rate-setting formula that leaders of both parties agree is flawed but would cost nearly $300 billion to permanently repeal.
On December 23rd, Congress passed the latest “doc fix,” delaying a looming 27.4% cut for two months as part of a larger deal to extend the payroll tax cut and unemployment benefits.
In an interview hours before congressional leaders announced the deal, Medicare’s deputy administrator, Jonathan Blum, observed that although the previous doc fix — a 13-month postponement finalized in December 2010 — also was enacted dangerously close to a deadline, “there were strong signals [beforehand] that Congress was coming together, and we were able to plan for that. But this, really to me, is a different scenario, where we don’t have clarity about what the timing of the ultimate policy will be”.
Hmmmnnn…apparently neither does Congress…
“Physicians still think that the people in Congress are too intelligent to let [the pay cut] happen,” said Alan Wasserman, president of George Washington University Medical Faculty Associates, one of the largest practices in Washington. “But we are concerned that as the rhetoric keeps getting turned up… areas of compromise just aren’t there anymore. Sooner or later, there is going to be an impasse”.
This latest fix expires on February 29.
“Congress now has to enact a real and fiscally responsible solution to this sorry cycle of scheduled cuts and short-term patches that compromises access to care for patients and drives up costs for taxpayers,” said Peter Carmel, president of the American Medical Association.
Doctors experienced a harrowing run of short-term fixes in 2010 — when Congress enacted five separate postponements. Both times CMS administrators were able to protect doctors by retroactively processing claims until Congress enacted the next fix. Based on past experience, Blum said, Medicare officials have determined that if Congress were to miss another deadline, the longest the program would hold off on processing physician payments would be 10 business days. After that, Medicare would begin paying claims at the lower rate with the expectation that officials could retroactively compensate doctors for the difference if a fix is passed.
With concern that the teeth-clenching nature of recent negotiations could prompt some doctors to stop seeing Medicare patients, Blum said the program is extending the usual Dec. 31 deadline by which doctors must notify Medicare of their plans to participate in the coming year. Doctors now will have until Feb. 14.
Let’s hope ‘Three Times the Charm’ this Valentine’s Day…
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