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Image courtesy Flickr user brianjmatis (Creative Commons) |
The dread of Tax Day is double for doctors this year. Not only are your income taxes due by midnight, but today Medicare will start gearing up to process claims that have been drastically reduced because of the Sustainable Growth Rate.
For years, Medicare has been set to reduce doctors’ fees because of the SGR, which was designed to hold spending in check. And for years, Congress has swooped in—often at the last minute—to stop the reductions, holding fees at or near the same rate as the year before. Repeat those dance steps for years until 2010 and now the statutorily mandated reduction is as much as 21%, depending on the doctor’s specialty.
This year, of course, health reform monopolized congressional attention and was passed without addressing the SGR. Then, Congress left town for a spring recess. Not surprising, many doctors and their professional societies were disappointed and angry.
Medicare decided to hold all claims for 10 business days but now that reprieve has expired. According to a press advisory sent out today by Medicare officials, “CMS has been holding April 2010 date-of-service claims, anticipating congressional action. But that has not occurred. Therefore, under current law, Medicare contractors will begin processing claims with dates of service April 1 and later at the negative update rates. This will begin as soon as systems are fully tested to ensure proper claims payment. And, Medicare contractors will pay these claims on a first in - first out basis.”
Exactly what day will systems be “fully tested to ensure proper claims payment”? That remains to be seen. Is Medicare trying to stall a bit longer? Could be. Will Congress ride into the rescue again? Legislation is shuttling back and forth between the House and the Senate right now.
Stay tuned.
Denise Fulton