Late last night, Congress passed the latest delay in the implementation of the 21.3% pay cut to the Medicare physician fee schedule. Unfortunately, the legislation was only acted upon urgently when CMS stated that by law they had no other option but to begin to process Part B claims for dates of service of April 1st and after with the pay cut beginning yesterday.

CMS will now instruct the contractors to reprocess all claims for services rendered after April 1st  that were processed on April 15th. This basically means that if you receive a Medicare explanation of benefits (EOMB) that is dated 4/15/2010, and the payments on charges reflect the cut, you should receive an EOMB from a subsequent date with the additional payment for these same charges.

This latest fix will be in effect until May 31st, 2010.  

We are now 3 1/2 months through the year, and a permanent fix to the Sustainable Growth Rate (SGR) formula has yet to be acted upon. There are only two visions of Congress running through my head when I think about this topic. The first has to do with the yellow-fingered denizens of a heroin shooting gallery craving their next balloon, and the second is that episode of the Three Stooges where they attempt to fix someone’s plumbing. Either one on its own is either horrifying or funny, but when blended together quickly becomes the nightmare scenario in which we now exist on a month-to-month basis.

I can clearly and unabashedly state that based on how American tax dollars were spent from 2001 through 2009, clearly legislative and budgetary ignorance are not particularly virtues of any one political party. Yet as the SGR rock is continually booted down an ever-darkening path as the sun sets on common sense, doctors and an ever-expanding Medicare population now walk a knife-edge, with physicians crunching future numbers wondering how to stay in the business of health care and elderly and infirmed patients wondering if they’ll be able to see a doctor at all.

In the last ten years, through either epic overreaching or near-criminal inaction, our government has either directly or indirectly broken budget surpluses, civil liberties, our court system, the ease of air travel, banking, housing, manufacturing, civil discourse, a bridge in Minneapolis, two buildings in New York City, Iraq, Afghanistan and the city of New Orleans.  Is it too much to ask that just one thing that directly affects the general welfare of a significant portion of our population gets fixed?

9:48 am, April 16th, 2010 |