Healthcare Business News

No Senate action on SGR; pay cut looms

By Jennifer Lubell
Posted: February 26, 2010 - 1:45 pm ET

Doctors on March 1 will face a 21% cut to Medicare physician payments because of the Senate's inability to act on a temporary measure to halt the scheduled reduction.

Legislation to stave off the cut to physician payments for 30 days passed easily enough in the House Thursday evening, but was blocked repeatedly in the Senate by retiring Sen. Jim Bunning (R-Ky.), who claims the fix to the sustainable growth-rate formula, along with other Medicare extensions in the bill, would add to the national debt.

Medical groups in statements voiced their immediate displeasure with lawmakers. “Our message to the U.S. Senate is stop playing games with Medicare patients and the physicians who care for them,” said J. James Rohack, president of the American Medical Association. “It is shocking that the Senate would abandon our most vulnerable patients, making them the collateral damage of their procedural games.”

This inaction “has put elderly and disabled patients at risk of losing access to care and imposed potentially devastating fiscal hardship on physicians,” said Lori Heim, president of the American Academy of Family Physicians. Kevin Burke, AAFP's director of government relations, expects the Senate will take up the SGR fix again early next week. The hope is the CMS will withhold Medicare payments to doctors until a temporary reprieve to the cuts is issued, to prevent physicians from having to re-file claims to restore the 21% cut, Burke said.

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CMS weighs in

Apparently, that's what the agency intends to do.

In an internal memo, the CMS instructed its contractors to hold claims on Medicare physician payments for the first 10 business days of March. This action “will only affect claims with dates of service March 1, 2010 and forward,” the agency clarified.

This hold should have a minimum impact on provider cash flow because, under current law, clean electronic claims are not paid any sooner than 14 calendar days (29 for paper claims) after the date of receipt, the memo stated.

“Whenever legislation is enacted to avoid negative updates, the CMS is prepared to act quickly to do everything in our authority to minimize disruption in payments to providers and make sure beneficiaries continue to get their healthcare services,” CMS spokesman Peter Ashkenaz said.

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