Senate Democrats move closer to passing bill that will delay Medicare pay cut slated for doctors

MedPage Today: Senate Democrats on Wednesday won a "key vote" toward delaying a 21 percent cut in physicians reimbursements from Medicare. Those cuts officially went into effect on April 1. On a 60-40 vote, the Senate agreed to exempt a provision to delay the cuts by Sen. Max Baucus, D-Mont., "from a Senate rule that says all spending legislation must be paid for."  Baucus' provision would delay the pay reductions until June 1. Those cuts are mandated by a law that links Medicare Part B reimbursements to increases in the gross domestic product. The full bill being considered by the Senate also "would temporarily extend funding for several federal programs that have expired, including unemployment benefits, COBRA health insurance subsidies for the unemployed, and the national flood insurance program. Senate Democrats have been trying to pass the measure since before they left for a two-week recess, but failed to do so because of Republican opposition. Republicans have blocked the bill because they don't approve of passing a bill that isn't paid for, while Democrats say the spending is for an 'emergency' and is therefore not subject to Senate rules that require all spending be offset" (Walker, 4/14).

KHN's Morning Edition includes more coverage of the COBRA subsidy extension.

McKnight's Long Term Care News: "CMS placed a hold on all Medicare physician claims for 10 business days in hopes that the Senate would address a physician pay fix before the end of that period. Many senators have balked at the bill's $9.2 billion price tag, since the funds were not offset by spending reductions elsewhere. It is estimated that a permanent fix to the physician pay problem would cost roughly $200 billion over 10 years. ... Another bill currently working its way through Congress, the American Workers, State and Business Relief Act, would delay the physician payment cut until Sept. 30" (4/15).

Medscape: "So what happens next to those suspended physician claims from the first 10 business days of April? ... [The Centers for Medicare and Medicaid] did issue guidance on a similar payment hold in January 2010 that may apply to the current situation. CMS had instructed carriers to sit on claims with January service dates for the first 10 business days of the month because it anticipated the possibility of the pay cut taking effect as scheduled on January 1, with Congress not acting to postpone it until later in January (in fact, Congress voted in late December to delay the cut until March 1, and followed up with another extension to April 1). On December 21, CMS announced on its Web site that after the end of the first 10 business days of January, suspended physician claims would enter the payment processing pipeline. ... CMS also stated that if Congress did eventually act to avert the cut, any claims processed at the reduced rate would be automatically reprocessed at the old higher rate, as long as what the physician charged was higher than the allowable amount in the slashed Medicare fee schedule" (Lowes, 4/14).

The Tucson Citizen: "Apparently, in 1997, Congress passed a law which said that if Medicare spending exceeds some complicated formula in a given year, Medicare fees to doctors must be trimmed the next year. Every year since, Medicare spending has grown enough to trigger the cuts to doctor fees. But every year, Congress has voted to ignore the law. Apparently, Congress never repealed the law because it allowed for some fuzzy accounting to make the Medicare budget look better. Health Beat blogger, Maggie Mahar, who has covered health care for many years in Washington, DC, says the 21% cut is never going to happen. Never has. Never will" (4/14).