That physicians have received another brief reprieve from the looming 21% cut to Medicare reimbursement is not the point, according to Dr. Karen S. Kolba.
The real issue is why physicians are being asked to bear the entire burden of higher-than-expected Medicare costs, she said in an interview. “I understand there are budget implications [to rising Medicare costs], but the responsibility to provide this benefit to seniors and the disabled is the duty of all citizens, not just physicians,” said Dr. Kolba, who is chair of the American College of Rheumatology's Committee on Rheumatologic Care.
President Obama signed legislation late on April 15 giving physicians another temporary reprieve from the 21% Medicare pay cut until June 1.
Dr. Kolba expects the cuts will not go through in this election year. The question is whether Congress will have the “guts” to fix the Sustainable Growth Rate (SGR) formula, said Dr. Kolba, who practices in Santa Maria, Calif.
The fate of Medicare's physician fees was in doubt as late as the afternoon of the 15th. The Senate spent most of the week debating a bill (H.R. 4851) that would delay the cuts mandated by the SGR formula as well as extend unemployment benefits and federal subsidies for COBRA benefits.
The Senate finally approved the bill, with the House doing so in quick succession. The president signed it shortly thereafter. The Congressional Budget Office estimated the cost of this brief delay in the pay cuts at $2.1 billion, the second most costly aspect of the bill after unemployment benefits extension, at almost $12 billion.
The pay cut technically went into effect on April 1, but the Centers for Medicare and Medicaid Services held all claims submitted from that date until April 15, in anticipation that Congress would reverse the cuts retroactively. But on the afternoon of the 15th, CMS officials noted in a statement that claims with dates of service on or after April 1 would be processed at the lower rate “as soon as systems are fully tested to ensure proper claims payment.”
Physician groups were not pleased and began chiding members of Congress for their inaction. J. James Rohack, president of the American Medical Association, said in a statement, “Congress must now turn toward solving this problem once and for all through repeal of the broken payment formula that will hurt seniors, military families, and the physicians who care for them.” Dr. Rohack warned—again—that physicians are starting to limit new Medicare patients. “It is impossible for physicians to continue to care for all seniors when Medicare payments fall so far below the cost of providing care,” he said.