Physicians once again find themselves staring at significantly lower Medicare fees for next year, based yet again on the Medicare Sustainable Growth Rate formula.
Under a stop-gap law passed in June, doctors are receiving a 2.2% increase in Medicare payments–but only through Nov. 30. In the absence of congressional action, that increase will be rolled back and the prior pay cut of approximately 21% will go into effect for the month of December.
For 2011, the proposed rule projects an additional 6.1% cut, starting on Jan. 1. “This means that under current law–that is, in the absence of additional legislative action–if a service is performed on Nov. 1 and Jan. 1, the payment for Jan. 1 will be about 30% lower” than the Nov. 1 payment, said Ellen Griffith-Cohen, a spokesperson for the Centers for Medicare and Medicaid Services.
Associations and policy makers say they expect Congress to once again address the pay cut before it goes into effect Nov. 30. But a consensus exists that the temporary fixes are no longer the answer.
“The APA is extremely concerned about the impending Medicare cuts, as we have been all along,” Nicholas Meyers, director of the American Psychiatric Association's department of government relations, wrote in a statement. “We have told Congress and the administration that these cuts and the uncertainty associated with these short term fixes are unacceptable and that a permanent solution must be reached.”
Meanwhile, both Democrats and Republicans in Congress are vying to be the party to fix the SGR formula. But there's doubt about any change in the Medicare payment system this year.
“I don't see anybody working on it hard enough right now to think that there's actually going to be a solution that's on the floor of the House right before or after the election,” Rep. Michael Burgess (R-Tex.) said at a recent Congressional Health Care Caucus forum. “That's just not going to happen.
“We'll probably do some other temporary patch to get into the next Congress,” said Rep. Burgess, who is an ob.gyn. He added that he hoped that the new majority in Congress will be Republican. “If we're going to show that we're different as a governing body in a new majority after the first of the year, we've got to fix this.”
In June, when the House passed the 6-month SGR delay, Rep. Frank Pallone (D-N.J.) addressed the Republicans when they spoke of a permanent fix: “When you talk about how we have a problem, well, I don't see you helping us out,” he said. “Don't kid those doctors and make them think you're going to vote for a permanent fix. You're never going to do it.”
The rule is open for comment until Aug. 24. To comment, visit www.regulations.gov