'Uncertainty creates total chaos for patients and physicians,' says ACP president, a practicing Georgia internist
"Because of Congress's inability to find answers to the ongoing Medicare physician payment dilemma, physicians across the country are unable to accept and treat new Medicare patients," Joseph W. Stubbs, MD, FACP, president of the American College of Physicians (ACP) declared today as he considered the impending effects of the cut to the Sustainable Growth Rate (SGR). "This is simply because the uncertainty creates total chaos from a business-planning perspective."
The 21 percent physician payment cut - that was originally scheduled to take effect on Jan. 1 - is set instead to begin on April 15. Twice before, at least month-long reprieves have staved off cuts before they could take effect. While Congress continues to work toward a further delay of the cuts, lawmakers have yet to agree on a pathway.
The Centers for Medicare and Medicaid Services (CMS) instructed its contracted-insurance companies to place a 10-day processing hold on claims for services provided on, or after, April 1. The "hold," CMS said, was to minimize administrative complications and other disruptions that would result from calculating payments that reflect a rate reduction that Congress is expected to overturn. By existing law, that 10-day hold period ends on Wednesday, April 14.
" If Medicare begins paying physician claims with the 21 percent reduction starting on April 15, any short-term fix that might be legislated this weekend or later - even though retroactive - likely will create a cash-flow problem in the meantime with claims being paid at the lower rate," Dr. Stubbs noted. "This will send an unfortunate message to Medicare beneficiaries.